Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia.
Faculty of Nutrition and Food Technology, Department of Clinical Nutrition, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Nutr Rev. 2024 May 10;82(6):804-814. doi: 10.1093/nutrit/nuad096.
The metabolic response to stress can deplete the remaining thiamine stores, leading to thiamine deficiency.
This study is the first meta-analysis of the effectiveness of thiamine supplementation on clinical and biochemical outcomes in adult patients admitted to the intensive care unit (ICU).
Scopus, PubMed, and Cochrane databases were searched to select studies up to 20 November 2022.
Studies investigating the effect of thiamine supplementation on serum lactate and creatinine levels, the need for renal replacement therapy, length of ICU stay, and mortality rate in ICU patients were selected.
After excluding studies based on title and abstract screening, 2 independent investigators reviewed the full texts of the remaining articles. In the next step, a third investigator resolved any discrepancy in the article selection process.
Of 1628 retrieved articles, 8 were selected for final analysis. This study showed that thiamine supplementation reduced the serum creatinine level (P = .03) compared with placebo. In addition, according to subgroup analysis, serum creatinine concentration was significantly lower in patients >60 years old (P < .00001). However, there was no statistically significant difference in the lactate level between the thiamine supplementation and placebo groups (P = .26). Thiamine supplementation did not decrease the risk of all-cause mortality (P = .71) or the need for renal replacement therapy (P = .14). The pooled results of eligible randomized controlled trials also showed that thiamine supplementation did not reduce the length of ICU stay in comparison to the placebo group (P = .39).
This meta-analysis provides evidence that thiamine supplementation has a protective effect against blood creatinine increase in ICU patients. However, further high-quality trials are needed to discover the effect of thiamine supplementation on clinical and biochemical outcomes in ICU patients.
PROSPERO no. CRD42023399710 (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=399710).
应激反应会消耗剩余的硫胺素储存，导致硫胺素缺乏。
本研究是对入住重症监护病房（ICU）的成年患者补充硫胺素对临床和生化结局影响的首次荟萃分析。
截至 2022 年 11 月 20 日，我们检索了 Scopus、PubMed 和 Cochrane 数据库，以选择研究。
我们选择了研究硫胺素补充对 ICU 患者血清乳酸和肌酐水平、肾脏替代治疗需求、ICU 住院时间和死亡率影响的研究。
在根据标题和摘要筛选排除研究后，2 名独立调查员审查了其余文章的全文。在下一个步骤中，第三名调查员解决了文章选择过程中的任何差异。
在 1628 篇检索到的文章中，有 8 篇被最终分析选中。本研究表明，与安慰剂相比，硫胺素补充降低了血清肌酐水平（P =.03）。此外，根据亚组分析，60 岁以上患者的血清肌酐浓度显著降低（P < .00001）。然而，硫胺素补充组与安慰剂组的乳酸水平无统计学差异（P =.26）。硫胺素补充并不能降低全因死亡率的风险（P =.71）或肾脏替代治疗的需求（P =.14）。合格的随机对照试验的汇总结果也表明，与安慰剂组相比，硫胺素补充并未缩短 ICU 住院时间（P =.39）。
本荟萃分析提供的证据表明，硫胺素补充对 ICU 患者血肌酐升高有保护作用。然而，还需要进一步的高质量试验来发现硫胺素补充对 ICU 患者临床和生化结局的影响。
PROSPERO 编号 CRD42023399710（https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=399710）。
