静脉注射硫胺素治疗脓毒性休克：一项随机对照试验的荟萃分析。

Intravenous thiamine for septic shock: A meta-analysis of randomized controlled trials.

机构信息

Emergency Department, The first people's hospital of yuhang district, Hangzhou, Zhejiang, China.

出版信息

Am J Emerg Med. 2020 Dec;38(12):2718-2722. doi: 10.1016/j.ajem.2020.08.050. Epub 2020 Aug 21.

DOI:10.1016/j.ajem.2020.08.050

PMID:33036854

Abstract

INTRODUCTION

The efficacy of intravenous thiamine to treat septic shock remains controversial. We conduct a systematic review and meta-analysis to explore the impact of intravenous thiamine on treatment efficacy of septic shock.

METHODS

We have searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through June 2020 and included randomized controlled trials (RCTs) assessing the effect of intravenous thiamine on septic shock. This meta-analysis was performed using the random-effect model.

RESULTS

Four RCTs were included in the meta-analysis. Overall, compared with control group in patients with septic shock, intravenous thiamine revealed no substantial impact on mortality (odd ratio [OR] = 0.87; 95% confidence interval [CI) = 0.62 to 1.21; P = 0.40), lactate change (standard mean difference [SMD] = 0.04; 95% CI = -0.28 to 0.35; P = 0.82), Sequential Organ Failure Assessment (SOFA) change (SMD = 0.02; 95% CI = -0.18 to 0.21; P = 0.87), intensive care unit (ICU) stay (SMD = -0.02; 95% CI = -0.33 to 0.30; P = 0.90) or renal replacement therapy (OR = 0.47; 95% CI = 0.07 to 3.15; P = 0.43).

CONCLUSIONS

Intravenous thiamine showed no benefit over placebo in treating patients with septic shock.

摘要

简介

静脉注射硫胺素治疗感染性休克的疗效仍存在争议。我们进行了系统评价和荟萃分析，以探讨静脉注射硫胺素对感染性休克治疗效果的影响。

方法

我们检索了 PubMed、EMbase、Web of science、EBSCO 和 Cochrane 图书馆数据库，检索时间截至 2020 年 6 月，纳入评估静脉注射硫胺素对感染性休克影响的随机对照试验（RCT）。本荟萃分析采用随机效应模型进行。

结果

共有 4 项 RCT 纳入荟萃分析。总体而言，与感染性休克患者的对照组相比，静脉注射硫胺素对死亡率（比值比 [OR] = 0.87；95%置信区间 [CI] = 0.62 至 1.21；P = 0.40）、乳酸变化（标准均数差 [SMD] = 0.04；95%CI = -0.28 至 0.35；P = 0.82）、序贯器官衰竭评估（SOFA）变化（SMD = 0.02；95%CI = -0.18 至 0.21；P = 0.87）、重症监护病房（ICU）入住时间（SMD = -0.02；95%CI = -0.33 至 0.30；P = 0.90）或肾脏替代治疗（OR = 0.47；95%CI = 0.07 至 3.15；P = 0.43）没有显著影响。