Thiamine combined with vitamin C in sepsis or septic shock: a systematic review and meta-analysis

作者：Ge, Zengzheng; Huang, Jiewu; Liu, Yawei; Xiang, Jun; Gao, Yanxia; Walline, Joseph Harold; Lu, Xin; Yu, Shiyuan; Zhao, Lina; Li, Yi^*

来源：European Journal of Emergency Medicine, 2021, 28(3): 189-195.

DOI：10.1097/MEJ.0000000000000812

• thiamine
• vitamin C
• sepsis
• septic shock
• meta-analysis

Background @@@ Thiamine and vitamin C have been increasingly used in patients with sepsis or septic shock because of their potential for improving metabolism and reducing mortality. @@@ Objective @@@ We aim to determine if thiamine combined vitamin C can reduce mortality in patients with sepsis or septic shock. @@@ Evidence sources and study selection @@@ We comprehensively searched the PubMed, Embase, Cochrane Library, and Web of Science databases from their inception dates through 1 January 2021. Literature works evaluating the efficacy of thiamine combined vitamin C in patients with sepsis or septic shock were considered. @@@ Data extraction and outcome measurements @@@ Two reviewers extracted data and assessed study quality. A meta-analysis was performed to calculate an odds ratio (OR), 95% confidence intervals (CIs), and P values for in-hospital mortality (primary outcome). Secondary outcomes included duration of ICU stay, duration of hospital stay, duration of vasopressor use, and change in sequential organ failure assessment (SOFA) scores. @@@ Results @@@ Seven randomized controlled trials were identified, encompassing a total of 868 patients. There was no statistical difference between groups for in-hospital mortality (OR: 1.11; 95% CI [0.79-1.56]; P = 0.55). Other than improving SOFA score during the first 72 h after enrollment and duration of vasopressor use, we found no other significant associations. @@@ Conclusions: @@@ Despite widespread enthusiasm for thiamine combined with vitamin C for sepsis and septic shock, we only found an association with reduced SOFA score and time of vasopressor use. There was no association with in-hospital mortality.

• 单位
  y; 中国医学科学院; 中国医学科学院北京协和医院; 南方医科大学; 郑州大学; 1