Thiamine combined with vitamin C in sepsis or septic shock: a systematic review and meta-analysis

source extracted confidence: high 2026-04-09
#ascorbic-acid #humans #sepsis #shock-septic #thiamine

Thiamine combined with vitamin C in sepsis or septic shock: a systematic review and meta-analysis

Ge et al., 2021 | Eur J Emerg Med | Meta Analysis

Citation

Ge Zengzheng, Huang Jiewu, ... Li Yi. Thiamine combined with vitamin C in sepsis or septic shock: a systematic review and meta-analysis. Eur J Emerg Med. 2021-Jun-01;28(3):189-195. doi:10.1097/MEJ.0000000000000812

Abstract

BACKGROUND: Thiamine and vitamin C have been increasingly used in patients with sepsis or septic shock because of their potential for improving metabolism and reducing mortality. OBJECTIVE: We aim to determine if thiamine combined vitamin C can reduce mortality in patients with sepsis or septic shock. EVIDENCE SOURCES AND STUDY SELECTION: We comprehensively searched the PubMed, Embase, Cochrane Library, and Web of Science databases from their inception dates through 1 January 2021. Literature works evaluating the efficacy of thiamine combined vitamin C in patients with sepsis or septic shock were considered. DATA EXTRACTION AND OUTCOME MEASUREMENTS: Two reviewers extracted data and assessed study quality. A meta-analysis was performed to calculate an odds ratio (OR), 95% confidence intervals (CIs), and P values for in-hospital mortality (primary outcome). Secondary outcomes included duration of ICU stay, duration of hospital stay, duration of vasopressor use, and change in sequential organ failure assessment (SOFA) scores. RESULTS: Seven randomized controlled trials were identified, encompassing a total of 868 patients. There was no statistical difference between groups for in-hospital mortality (OR: 1.11; 95% CI [0.79-1.56]; P = 0.55). Other than improving SOFA score during the first 72 h after enrollment and duration of vasopressor use, we found no other significant associations. CONCLUSIONS: Despite widespread enthusiasm for thiamine combined with vitamin C for sepsis and septic shock, we only found an association with reduced SOFA score and time of vasopressor use. There was no association with in-hospital mortality.

Key Findings

Seven randomized controlled trials were identified, encompassing a total of 868 patients. There was no statistical difference between groups for in-hospital mortality (OR: 1.11; 95% CI [0.79-1.56]; P = 0.55). Other than improving SOFA score during the first 72 h after enrollment and duration of vasopressor use, we found no other significant associations.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population sepsis or septic shock
Sample Size 868
Age Range See abstract
Condition See abstract

MeSH Terms

  • Ascorbic Acid
  • Humans
  • Sepsis
  • Shock, Septic
  • Thiamine
  • Vitamins

Evidence Classification

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

Provenance

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