Thiamin supplementation associated with reduced mortality in septic shock patients.

This systematic review and meta-analysis pooled data from randomized controlled trials involving 438 patients with septic shock. The intervention consisted of thiamin supplementation, compared against placebo or blank controls. The primary outcome assessed was in-hospital mortality, with renal replacement therapy as a secondary outcome.

The analysis reported a significant reduction in in-hospital mortality, with a risk ratio of 0.80 (95% CI 0.65-0.99; P = 0.04). Similarly, the use of renal replacement therapy was significantly reduced, with a risk ratio of 0.48 (95% CI 0.31-0.74; P = 0.0009). Absolute numbers for these outcomes were not reported in the source data.

Safety and tolerability data, including adverse events, serious adverse events, and discontinuations, were not reported. The study phase was not reported, and funding or conflicts of interest were not disclosed. The authors note that the effectiveness of thiamin supplementation in mitigating renal injury and mortality outcomes in patients with septic shock remains uncertain.

While the practice relevance suggests thiamin should be considered for patients with septic shock, clinicians must interpret these results cautiously given the uncertainty regarding causality and the lack of safety reporting. These findings should not be viewed as definitive proof of efficacy without further high-quality evidence.