Intravenous thiamine for septic shock: A meta-analysis of randomized controlled trials

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#humans #administration-intravenous #intensive-care-units #mortality #odds-ratio

Intravenous thiamine for septic shock: A meta-analysis of randomized controlled trials

Qian et al., 2020 | Am J Emerg Med | Meta Analysis

Citation

Qian Xiangfeng, Zhang Zhe, ... Wu Longchuan. Intravenous thiamine for septic shock: A meta-analysis of randomized controlled trials. Am J Emerg Med. 2020-Dec;38(12):2718-2722. doi:10.1016/j.ajem.2020.08.050

Abstract

INTRODUCTION: The efficacy of intravenous thiamine to treat septic shock remains controversial. We conduct a systematic review and meta-analysis to explore the impact of intravenous thiamine on treatment efficacy of septic shock. METHODS: We have searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through June 2020 and included randomized controlled trials (RCTs) assessing the effect of intravenous thiamine on septic shock. This meta-analysis was performed using the random-effect model. RESULTS: Four RCTs were included in the meta-analysis. Overall, compared with control group in patients with septic shock, intravenous thiamine revealed no substantial impact on mortality (odd ratio [OR] = 0.87; 95% confidence interval [CI) = 0.62 to 1.21; P = 0.40), lactate change (standard mean difference [SMD] = 0.04; 95% CI = -0.28 to 0.35; P = 0.82), Sequential Organ Failure Assessment (SOFA) change (SMD = 0.02; 95% CI = -0.18 to 0.21; P = 0.87), intensive care unit (ICU) stay (SMD = -0.02; 95% CI = -0.33 to 0.30; P = 0.90) or renal replacement therapy (OR = 0.47; 95% CI = 0.07 to 3.15; P = 0.43). CONCLUSIONS: Intravenous thiamine showed no benefit over placebo in treating patients with septic shock.

Key Findings

Four RCTs were included in the meta-analysis. Overall, compared with control group in patients with septic shock, intravenous thiamine revealed no substantial impact on mortality (odd ratio [OR] = 0.87; 95% confidence interval [CI) = 0.62 to 1.21; P = 0.40), lactate change (standard mean difference [SMD] = 0.04; 95% CI = -0.28 to 0.35; P = 0.82), Sequential Organ Failure Assessment (SOFA) change (SMD = 0.02; 95% CI = -0.18 to 0.21; P = 0.87), intensive care unit (ICU) stay (SMD = -0.02; 95% CI =

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population septic shock
Sample Size See abstract
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Administration, Intravenous
  • Intensive Care Units
  • Mortality
  • Odds Ratio
  • Organ Dysfunction Scores
  • Randomized Controlled Trials as Topic
  • Renal Replacement Therapy
  • Shock, Septic
  • Thiamine
  • Vitamin B Complex

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: thiamine

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09