Associations between early thiamine administration and clinical outcomes in critically ill patients with acute kidney injury

Li, Xunliang; Luan, Hong; Zhang, Hui; Li, Chenyu; Bu, Quandong; Zhou, Bin; Tang, Nina; Zhou, Haiyan; Xu, Yan; Jiang, Wei; Zhao, Liang; Man, Xiaofei; Che, Lin; Wang, Yanfei; Luo, Congjuan; Sun, Jianping

doi:10.1017/s0007114521003111

Cited by 5 publications

(3 citation statements)

References 40 publications

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“…After analyzing data from the retrospective cohort study of patients from the Medical Information Mart for Intensive Care III (MIMIC III) database, an advantage of early thiamine administration in critically ill patients with acute kidney injury was reported by Li et al [8 ▪ ] who found an improvement of in-hospital and 90-days mortality. Also, using the same database, Hu et al [10] found that the administration of thiamine to septic individuals with alcohol use disorder who are in a critical condition may potentially result in a reduced mortality rate [9].…”

Section: Thiamine Deficiency During Critical Illnessmentioning

confidence: 99%

Metabolic failure due to thiamine deficiency during critical illness

Cobilinschi,

Andrei,

Grinţescu

et al. 2024

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Purpose of review Thiamine is a crucial component in cellular energy metabolism, serving as a cofactor for multiple enzymatic processes and also having a role in regulating neuronal and neuromuscular transmission. Also it exerts antioxidant proprieties. The objective of this review is to consolidate and assess the most recent research concerning the consequences of insufficient thiamine levels for critically ill patients and to examine thiamine-related interventions. Recent findings Recent studies have unveiled a noteworthy association between thiamine deficiency and unfavorable consequences, such as heightened morbidity and fatality rates. The aforementioned deficiency exhibits a significant presence in medical situations such as starvation and alcohol use disorder, but also in patients during critical illness. Thiamine deficiency can have significant metabolic implications resulting in compromised energy generation and organ dysfunction, warranting prompt recognition and management. Summary Thiamine deficiency may not be recognized in critical care. Timely identification and management are imperative to mitigate adverse outcomes and improve patient prognosis. Thiamine may offer benefits for specific patient groups at higher risk of deficiency. Future studies should focus to establish optimal dosing, timing, and monitoring strategies on understanding the pathophysiological changes associated with thiamine deficiency in ICU patients and clarify its role in improving clinical outcomes.

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Section: Thiamine Deficiency During Critical Illnessmentioning

confidence: 99%

Metabolic failure due to thiamine deficiency during critical illness

Cobilinschi,

Andrei,

Grinţescu

et al. 2024

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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“…For example, thiamine combined with hydrocortisone and ascorbic acid to form HAT therapy in patients with sepsis is associated with improved organ dysfunction, reduced sequential organ failure assessment scores, increased lactate clearance, and decreased mortality ( Marik et al, 2017 ; Litwak et al, 2019 ). Moreover, the application of thiamine can significantly reduce the mortality of patients with ventilator-associated pneumonia and acute kidney injury in the ICU settings ( Li et al, 2022 ; Zhang et al, 2022 ). Thiamine deficiency, resulting in the accumulation of pyruvate and its conversion to lactic acid, causes a decrease in peripheral resistance, thereby increasing venous return to the heart (preload).…”

Section: Introductionmentioning

confidence: 99%

Association of thiamine administration and prognosis in critically ill patients with heart failure

et al. 2023

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Background: Thiamine deficiency is common in patients with heart failure, and thiamine supplement can benefit these patients. However, the association between thiamine administration and prognosis among critically ill patients with heart failure remains unclear. Thus, this study aims to prove the survival benefit of thiamine use in critically ill patients with heart failure.Methods: A retrospective cohort analysis was performed on the basis of the Medical Information Mart of Intensive Care-Ⅳ database. Critically ill patients with heart failure were divided into the thiamine and non-thiamine groups depending on whether they had received thiamine therapy or not during hospitalization. The association between thiamine supplement and in-hospital mortality was assessed by using the Kaplan−Meier (KM) method and Cox proportional hazard models. A 1:1 nearest propensity-score matching (PSM) and propensity score-based inverse probability of treatment weighting (IPW) were also performed to ensure the robustness of the findings.Results: A total of 7,021 patients were included in this study, with 685 and 6,336 in the thiamine and non-thiamine groups, respectively. The kaplan−meier survival curves indicated that the thiamine group had a lower in-hospital mortality than the none-thiamine group. After adjusting for various confounders, the Cox regression models showed significant beneficial effects of thiamine administration on in-hospital mortality among critically ill patients with heart failure with a hazard ratio of 0.78 (95% confidence interval: 0.67–0.89) in the fully adjusted model. propensity-score matching and probability of treatment weighting analyses also achieved consistent results.Conclusion: Thiamine supplement is associated with a decreased risk of in-hospital mortality in critically ill patients with heart failure who are admitted to the ICU. Further multicenter and well-designed randomized controlled trials with large sample sizes are necessary to validate this finding.

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“…However, whether this population benefits from these treatment options remains controversial ( 6 ). Fluid and electrolyte management, metabolic stabilization, and nutritional supplements including diuretics, sodium bicarbonate, ondansetron, and thiamine also have been investigated in critically ill patients with AKI ( 7 – 9 ).…”

Section: Introductionmentioning

confidence: 99%

The Impact of Zinc Supplementation on Critically Ill Patients With Acute Kidney Injury: A Propensity Score Matching Analysis

Xia

Zhao

et al. 2022

Front. Nutr.

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BackgroundZinc is an essential trace element involved in multiple metabolic processes. Acute kidney injury (AKI) is associated with low plasma zinc, but outcomes with zinc supplementation in critically ill patients with AKI remain unknown. Our objective was to investigate the effectiveness of zinc supplementation in this patient population.MethodsCritically ill patients with AKI were identified from the Medical Informative Mart for Intensive Care IV database. Prosperity score matching (PSM) was applied to match patients receiving zinc treatment to those without zinc treatment. The association between zinc sulfate use and in-hospital mortality and 30-day mortality, need for renal replacement therapy (RRT), and length of stay was determined by logistic regression and Cox proportional hazards modeling.ResultsA total of 9,811 AKI patients were included in the study. PSM yielded 222 pairs of patients who received zinc treatment and those who did not. Zinc supplementation was associated with reduced in-hospital mortality (HR = 0.48 (95% CI: 0.28, 0.83) P = 0.009) and 30-day mortality (HR = 0.51 (95% CI, 0.30, 0.86) P = 0.012). In the subgroup analysis, zinc use was associated with reduced in-hospital mortality in patients with stage 1 AKI and those with sepsis.ConclusionsZinc supplementation was associated with improved survival in critically ill patients with AKI. The supplementation was especially effective in those with stage 1 AKI and sepsis. These results need to be verified in randomized controlled trials.

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Associations between early thiamine administration and clinical outcomes in critically ill patients with acute kidney injury

Cited by 5 publications

References 40 publications

Metabolic failure due to thiamine deficiency during critical illness

Metabolic failure due to thiamine deficiency during critical illness

Association of thiamine administration and prognosis in critically ill patients with heart failure

The Impact of Zinc Supplementation on Critically Ill Patients With Acute Kidney Injury: A Propensity Score Matching Analysis

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