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| Author(s): |
Amanda Gomes Pereira
Total Authors: 1
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| Document type: | Doctoral Thesis |
| Press: | Botucatu. 2022-07-28. |
| Institution: | Universidade Estadual Paulista (Unesp). Faculdade de Medicina. Botucatu |
| Defense date: | 2022-02-24 |
| Advisor: | Bertha Furlan Polegato |
| Abstract | |
Introduction: Septic shock is characterized by hypotension and tissue hypoperfusion, associated with increased lactate, refractory to appropriate volume expansion, and requiring the use of vasopressors to maintain hemodynamic stability. Due to its high mortality, supporting therapies have been explored to improve the prognosis of patients. In this sense, studies have explored the role of thiamine as a metabolic resuscitator in patients with septic shock. Aims: To evaluate the influence of thiamine supplementation on mortality in patients with septic shock. Methods: A prospective, controlled, double-blind, randomized study that included 115 consecutive patients, over 18 years old, diagnosed with septic shock on admission to the Intensive Care Unit (ICU). The patients were divided into two groups: thiamine supplementation (200 mg every 12 hours, intravenous, for 5 days) and placebo (saline solution 0.9% in volume, frequency, and period equal to thiamine). Clinical, laboratory data and blood samples were collected before the start of thiamine administration and 48 hours after. Results: 57 patients were in the thiamine group and 58 patients in the placebo group. The mean age was 63.3 ± 15.7 years and 55.6% were male. The median serum thiamine values before treatment were 35.4 ng/mL (24.7 - 51.9) and only 8% of patients (n = 9) having a deficiency (<16 ng/mL). After 48 hours, the median serum thiamine concentrations were 51.5 (35.6 - 85.3) ng/mL and 33.7 (21.5 - 52.8) ng/mL (p = 0.003) in the thiamine and placebo group, respectively. The median ICU and hospital length of stay were 7 (4 - 16) days and 16 (9 - 30) days, respectively. The 28-days mortality was 58.2% (n = 67). There was no statistically significant difference in mortality between the groups (Thiamine: 32 [56.1%] vs. Placebo: 35[60.3%]), as well as the length of ICU and hospital stay, and ventilator and vasopressor-free days. Conclusion: Thiamine administration of 400 mg for 5 days did not affect mortality in patients with septic shock. (AU) | |
| FAPESP's process: | 17/21554-5 - Influence of thiamine suplementation in oxidative stress, energetic metabolism and mortality among patients with septic shock |
| Grantee: | Amanda Gomes Pereira |
| Support Opportunities: | Scholarships in Brazil - Doctorate |