Randomized, Double-Blind, Placebo-Controlled Trial of Thiamine as a Metabolic Resuscitator in Septic Shock: A Pilot Study

Critical Care Medicine
Michael W DonninoCenter for Resuscitation Science Research Group

Abstract

To determine if intravenous thiamine would reduce lactate in patients with septic shock. Randomized, double-blind, placebo-controlled trial. Two US hospitals. Adult patients with septic shock and elevated (> 3 mmol/L) lactate between 2010 and 2014. Thiamine 200 mg or matching placebo twice daily for 7 days or until hospital discharge. The primary outcome was lactate levels 24 hours after the first study dose. Of 715 patients meeting the inclusion criteria, 88 patients were enrolled and received study drug. There was no difference in the primary outcome of lactate levels at 24 hours after study start between the thiamine and placebo groups (median: 2.5 mmol/L [1.5, 3.4] vs. 2.6 mmol/L [1.6, 5.1], p = 0.40). There was no difference in secondary outcomes including time to shock reversal, severity of illness and mortality. 35% of the patients were thiamine deficient at baseline. In this predefined subgroup, those in the thiamine treatment group had statistically significantly lower lactate levels at 24 hours (median 2.1 mmol/L [1.4, 2.5] vs. 3.1 [1.9, 8.3], p = 0.03). There was a statistically significant decrease in mortality over time in those receiving thiamine in this subgroup (p = 0.047). Administration of thiamine did not imp...Continue Reading

References

Jan 1, 1988·Intensive Care Medicine·A M CruickshankA Shenkin
Oct 1, 1985·Critical Care Medicine·W A KnausJ E Zimmerman
Sep 21, 2002·BMJ : British Medical Journal·Dean FergussonPaul Hébert
May 29, 2004·The American Journal of the Medical Sciences·Alex P BetrosianNikolaos Sevastos
Apr 13, 2007·Cellular and Molecular Life Sciences : CMLS·R A W FrankB F Luisi
Jul 21, 2007·Southern Medical Journal·Scott BoniolGary V Burton
Aug 8, 2007·Annals of Emergency Medicine·Michael W DonninoMark Walsh
Nov 26, 2009·Journal of Tropical Pediatrics·S Narasimha Rao, G R Chandak
Dec 17, 2009·Nutrition·Michael W DonninoJustin Salciccioli
Jul 22, 2010·Journal of Critical Care·Michael W DonninoLong Ngo
Nov 12, 2010·The American Journal of Clinical Nutrition·Lúcio Flávio Peixoto de LimaJosé Augusto de A C Taddei
Sep 14, 2011·Current Opinion in Clinical Nutrition and Metabolic Care·William Manzanares, Gil Hardy
Jul 16, 2013·The Journal of Emergency Medicine·Makini Chisolm-Straker, David Cherkas
Jul 19, 2013·The Neuroradiology Journal·V K Kotha, A De Souza
Oct 2, 2013·Mayo Clinic Proceedings·Lars W AndersenMichael W Donnino
Jan 15, 2014·Journal of Critical Care·Nara Aline CostaMarcos Ferreira Minicucci
Mar 19, 2014·The New England Journal of Medicine·Donald M YealyDerek C Angus
Apr 30, 2014·Critical Care Medicine·Michael W DonninoUNKNOWN National Post-Arrest Research Consortium
Oct 2, 2014·The New England Journal of Medicine·Sandra L PeakePatricia Williams
Oct 15, 2014·BMC Research Notes·Stefano BusaniMassimo Girardis
Dec 18, 2014·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Marilù GiacaloneFrancesco Forfori
Mar 18, 2015·The New England Journal of Medicine·Paul R MounceyUNKNOWN ProMISe Trial Investigators

❮ Previous
Next ❯

Citations

Apr 6, 2016·Critical Care : the Official Journal of the Critical Care Forum·Lars W AndersenMichael W Donnino
Dec 31, 2015·Shock·Lars W AndersenMichael W Donnino
Jul 6, 2016·Frontiers in Nutrition·Laurent HifflerDaniel Martinez Garcia
Oct 19, 2016·The American Journal of Emergency Medicine·Maira BenattiCarlos Henrique Miranda
Jul 22, 2016·Journal of Intensive Care Medicine·Wouter van SnippenburgPeter E Spronk
Jun 5, 2018·Current Opinion in Critical Care·Angélique M E Spoelstra-de ManHeleen M Oudemans-Van Straaten
Aug 29, 2018·Annals of the New York Academy of Sciences·Kyly C WhitfieldGerald F Combs
Sep 15, 2018·Critical Care Medicine·Paul E Marik
Jul 22, 2018·Critical Care Medicine·Jordan A WoolumAlexander H Flannery
Oct 13, 2018·Critical Care Medicine·Paul E Marik
Nov 8, 2018·Antioxidants & Redox Signaling·Vera A ReitsemaHjalmar R Bouma
Mar 10, 2018·Intensive Care Medicine·Karin AmreinMette M Berger
Jan 16, 2019·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Kursat GundoganThomas R Ziegler
Jan 16, 2019·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Bertha F PolegatoMarcos F Minicucci
Feb 6, 2019·Current Opinion in Anaesthesiology·Mark E Nunnally, Arpit Patel
Mar 17, 2017·Advances in Nutrition·Jennifer C Kerns, Jean L Gutierrez
Nov 28, 2017·Current Opinion in Anaesthesiology·Sven-Olaf KuhnKarsten Bartels
Sep 5, 2019·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Halden F Scott
Jan 18, 2020·JAMA : the Journal of the American Medical Association·Andre C Kalil
Feb 8, 2020·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Scott L WeissPierre Tissieres
Apr 14, 2020·Journal of Intensive Care Medicine·Jacob C Jentzer, Steven M Hollenberg
Apr 23, 2017·Clinical Chemistry and Laboratory Medicine : CCLM·Jake T B CollieRinaldo Bellomo
May 29, 2019·Critical Care Nursing Quarterly·Jacob P CountsG Morgan Jones
Jul 10, 2020·Archives of Physiology and Biochemistry·Fatemeh BourBourSaied Doaei
Aug 5, 2020·Der Anaesthesist·Andre KramerMichael Bernhard
Aug 12, 2020·Intensive Care Medicine·Sung Yeon HwangUNKNOWN Korean Shock Society (KoSS)
Aug 19, 2020·JAMA : the Journal of the American Medical Association·Ari MoskowitzUNKNOWN ACTS Clinical Trial Investigators
Aug 19, 2020·Expert Review of Anti-infective Therapy·Paul E MarikG Umberto Meduri
Sep 17, 2020·Journal of Pharmacy Practice·Melissa Chudow, Beatrice Adams
Jun 20, 2018·Molecules : a Journal of Synthetic Chemistry and Natural Product Chemistry·Xiaowen LiuMichael W Donnino
Oct 31, 2018·Critical Care : the Official Journal of the Critical Care Forum·Ari MoskowitzMichael W Donnino
May 8, 2019·BMC Complementary and Alternative Medicine·Howard A SmithlinePaul Visintainer

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.