Efficacy of thiamine (vitamin B1) in sepsis and septic shock: A meta-analysis of randomized controlled trials

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics Pub Date : 2026-01-01 Epub Date: 2026-03-20 DOI:10.1016/j.clinsp.2026.100901

Xiaoqin Xu, Xiaoqi Bai, Wei Cao, Danting Fei, Dandan Yang, Xuning Shen, Jun Xu, Dongjun Xu

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引用次数: 0

Abstract

Objective

To perform a meta-analysis evaluating thiamine’s efficacy for sepsis and septic shock to support its clinical use.

Methods

The meta-analysis of randomized controlled studies on patients with sepsis and septic shock evaluated the efficacy of intravenous thiamine. Articles were retrieved from online databases. Qualities of included studies were assessed.

Results

Nine studies enrolling 520 patients were included. Regarding bias risk assessment of studies, two articles were classified as low risk, three were categorized as raising some concerns, and four were identified as high risk. Patients in the thiamine group were significantly associated with decreased proportion of Renal Replacement Therapy (RRT, Odds Ratio [OR = 0.26], p = 0.0007), decreased 24 h lactate level (Mean Difference [MD = -0.35], p = 0.004), and larger 24 h SOFA score change (MD = 1.15, p < 0.00001). No statistical significance was detected in short-time mortality (OR = 0.78, p = 0.18) and 24 h lactate change (MD = 0.09, p = 0.36) between the two groups. In the thiamine-deficient subgroup (2 studies, 51 patients), exploratory analysis indicated a potential short-term mortality reduction with thiamine (OR = 0.18, p = 0.01), though limited by the small sample size.

Conclusion

This meta-analysis preliminarily suggested that thiamine may exert a potential role in improving organ dysfunction among patients with sepsis and septic shock. No significant benefit of thiamine in reducing short-term mortality was observed. It is important to note that the total number of patients included in this meta-analysis is relatively small, which limits the statistical power and external validity of the results.

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硫胺素（维生素B1）在脓毒症和感染性休克中的疗效：一项随机对照试验的荟萃分析。

目的：通过荟萃分析评价硫胺素治疗脓毒症和感染性休克的疗效，以支持其临床应用。方法：对脓毒症和感染性休克患者的随机对照研究进行meta分析，评价静脉注射硫胺素的疗效。文章从在线数据库中检索。评估纳入研究的质量。结果：纳入了9项研究，共纳入520例患者。关于研究的偏倚风险评估，两篇文章被归类为低风险，三篇文章被归类为引起关注，四篇文章被确定为高风险。硫胺素组患者肾替代治疗比例降低（RRT，比值比[OR = 0.26], p = 0.0007）， 24 h乳酸水平降低（平均差值[MD = -0.35], p = 0.004）， 24 h SOFA评分变化较大（MD = 1.15, p < 0.00001）。两组患者短期死亡率（OR = 0.78, p = 0.18）和24 h乳酸变化（MD = 0.09, p = 0.36）比较，差异均无统计学意义。在硫胺素缺乏亚组（2项研究，51例患者）中，探索性分析表明，尽管受样本量小的限制，硫胺素可降低潜在的短期死亡率（OR = 0.18, p = 0.01）。结论：本荟萃分析初步提示硫胺素可能在改善脓毒症和感染性休克患者器官功能障碍中发挥潜在作用。没有观察到硫胺素在降低短期死亡率方面的显著益处。值得注意的是，本荟萃分析纳入的患者总数相对较少，这限制了结果的统计效力和外部有效性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinics 医学-医学：内科

CiteScore

4.10

自引率

3.70%

发文量

129

审稿时长

52 days

期刊介绍： CLINICS is an electronic journal that publishes peer-reviewed articles in continuous flow, of interest to clinicians and researchers in the medical sciences. CLINICS complies with the policies of funding agencies which request or require deposition of the published articles that they fund into publicly available databases. CLINICS supports the position of the International Committee of Medical Journal Editors (ICMJE) on trial registration.