Thiamine for Septic Shock: Clinical Outcomes and Updates

• DOI: https://doi.org/10.22533/at.ed.1594632428068

• Palavras-chave: Thiamine; Septic shock; Sepsis.

• Keywords: Thiamine; Septic shock; Sepsis.

• Abstract:

  Objective: To examine the effectiveness of thiamine in improving clinical outcomes of patients with septic shock, including mortality, length of hospital stays, and need for organ support, and to update clinical guidelines based on the latest evidence. Methods: Literature review developed according to the criteria of the PVO strategy through its guiding question: “How does thiamine supplementation influence the clinical outcomes of patients with septic shock?”. The searches were carried out using the PubMed database using the search strategy: (septic shock) OR (sepsis) AND (thiamine). Immediately after applying the inclusion and exclusion criteria, 16 articles were selected to form the collection of this study. Review: The use of thiamine for septic shock is discussed, analyzing the effectiveness of this treatment in improving clinical outcomes in critically ill patients. Although initial studies suggest benefits, such as maintaining adequate blood pH and preserving cardiac and neurological function, studies in humans have shown inconsistent results, especially in relation to reduced mortality. Thiamine showed potential in eliminating lactate and controlling oxidative stress, suggesting a therapeutic role in specific cases. More rigorous studies are still needed to confirm these benefits, given the variability of the results observed. Final considerations: The results indicate that thiamine can improve some metabolic parameters and reduce mortality in certain cases, but the evidence is inconsistent, requiring further studies. The safety profile of thiamine is good and has therapeutic potential, but its effectiveness varies depending on the patient's metabolic status and the presence of thiamine deficiency. Future research must focus on identifying which patients benefit most from its use and optimizing dosages and administration methods.