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Journal of critical care · Oct 2021
Meta AnalysisEffect of thiamine supplementation in critically ill patients: A systematic review and meta-analysis.
- SedhaiYub RajYRDepartment of Internal Medicine, Division of Hospital Medicine, Virginia Commonwealth University, School of Medicine, Richmond, VA, USA. Electronic address: YubRaj.Sedhai@vcuhealth.org., Dhan Bahadur Shrestha, Pravash Budhathoki, Vivek Jha, Sujit Kumar Mandal, Saurab Karki, Ramkaji Baniya, Casey A Cable, and Markos G Kashiouris.
- Department of Internal Medicine, Division of Hospital Medicine, Virginia Commonwealth University, School of Medicine, Richmond, VA, USA. Electronic address: YubRaj.Sedhai@vcuhealth.org.
- J Crit Care. 2021 Oct 1; 65: 104-115.
IntroductionSeveral studies have previously shown the benefit of thiamine supplementation in critically ill patients. In order to fully appraise the available data, we performed a meta-analysis of 18 published studies.MethodsA thorough systematic search was conducted. The studies enrolling critically ill patients receiving thiamine supplementation was compared with the standard of care (SOC) group. Data was analyzed using RevMan 5.4. Clinical outcomes were pooled using Odds Ratio (OR) and mean differences.ResultEighteen studies (8 RCTs and 10 cohort studies) met the criteria for quantitative synthesis. In the analysis of RCTs, thiamine supplementation showed 42% lower odds of developing ICU delirium (OR 0.58, 95% CI, 0.34-0.98). A reduction in mortaliy was observed on performing fixed effect model analysis however, a level of statistical significance could not be reached on performing random effect model analysis (OR, 0.78; 95% CI, 0.59 to 1.04). Further sub-group analysis of 13 studies in patients with sepsis, there was no difference in mortality between the two groups (OR, 0.83; 95% CI, 0.63 to 1.09).ConclusionThiamine supplementation in critically ill patients showed a reduction in the incidence of ICU delirium among RCTs. However, there was no significant benefit in terms of overall mortality, and mortality in patients with sepsis. Further, large scale randomized prospective studies are warranted to investigate the role of thiamine supplementation in critically ill patients.Copyright © 2021 Elsevier Inc. All rights reserved.
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