Skip to main content
Evidence-Based Supplement Research
Evidence-Based Supplement Research
Pillser
Search
Sign UpLog In

Effect of intravenous thiamine administration on critically ill patients: A systematic review and meta-analysis of randomized controlled trials.

  • 2024-11
  • Clinical nutrition (Edinburgh, Scotland) 43(11)
    • Nobuto Nakanishi
    • Yoshinobu Abe
    • Mizue Matsuo
    • Akihito Tampo
    • Kohei Yamada
    • Junji Hatakeyama
    • Minoru Yoshida
    • Ryo Yamamoto
    • Naoki Higashibeppu
    • Kensuke Nakamura
    • Joji Kotani

Study Design

Type
Meta-Analysis
Sample size
n = 3,494
Population
critically ill patients
Methods
systematic review and meta-analysis; literature search was conducted in MEDLINE, CENTRAL, and ICHUSHI databases from inception to April 2023

Background &aims

Thiamine is an essential micronutrient for energy metabolism. Thiamine deficiency is frequently observed in critically ill patients. However, the effect of thiamine administration is unclear in critically ill patients.

Methods

We conducted a systematic review and meta-analysis. To identify randomized controlled trials on the effect of thiamine administration in critically ill patients, a literature search was conducted in MEDLINE, CENTRAL, and ICHUSHI databases from inception to April 2023. Pooled effect estimates were calculated about mortality as the primary outcome and shock duration, lactate level, Sequential Organ Failure Assessment (SOFA) score, delirium, length of mechanical ventilation, length of intensive care unit (ICU) stay, infection rate, all adverse events, and Short-Form Health Survey (SF-36) as the secondary outcomes. The certainty of evidence (CoE) was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach.

Results

Overall, 35 studies (3494 patients) were included. Evidence suggested that thiamine administration resulted in little to no difference in mortality (risk ratio [RR], 0.89; 95% confidence interval [CI], 0.75 to 1.06; Low CoE); however, thiamine administration may reduce shock duration (mean difference [MD], -11.43 h; 95% CI, -20.16 to -2.69 h; Low CoE), lactate level (MD, -0.34 mmol/L; 95% CI, -0.63 to -0.05 mmol/L; Low CoE), and SOFA score (MD, -1.29; 95% CI, -1.91 to -0.66; Low CoE). Conversely, thiamine administration resulted in a slight increase in the length of ICU stay (MD, 0.40 days; 95% CI, 0.01-0.79 days; High CoE).

Conclusions

Although thiamine administration may reduce shock state, it may not reduce mortality, and slightly increases the length of ICU stay.

Research Insights

  • Vitamin B1→Reduced Lactate Levels

    thiamine administration may reduce ... lactate level (MD, -0.34 mmol/L; 95% CI, -0.63 to -0.05 mmol/L; Low CoE)

    Effect
    Beneficial
    Effect size
    Small
  • Vitamin B1→Reduced Length of Intensive Care Unit Stay

    thiamine administration resulted in a slight increase in the length of ICU stay (MD, 0.40 days; 95% CI, 0.01-0.79 days; High CoE)

    Effect
    Harmful
    Effect size
    Small
  • Vitamin B1→Reduced Mortality Risk

    Evidence suggested that thiamine administration resulted in little to no difference in mortality (risk ratio [RR], 0.89; 95% confidence interval [CI], 0.75 to 1.06; Low CoE)

    Effect
    Neutral
    Effect size
    Small
  • Vitamin B1→Reduced SOFA Score

    thiamine administration may reduce ... SOFA score (MD, -1.29; 95% CI, -1.91 to -0.66; Low CoE)

    Effect
    Beneficial
    Effect size
    Small
  • Vitamin B1→Reduced Shock Duration

    thiamine administration may reduce shock duration (mean difference [MD], -11.43 h; 95% CI, -20.16 to -2.69 h; Low CoE)

    Effect
    Beneficial
    Effect size
    Moderate
Back to top