背景:对压力的代谢反应可以耗尽剩余的硫胺素储备,导致硫胺素缺乏。
目的:本研究是对重症监护病房(ICU)成年患者补充硫胺素对临床和生化结果有效性的首次荟萃分析。
方法:Scopus,PubMed,和Cochrane数据库进行搜索,以选择截至2022年11月20日的研究。
方法:研究补充硫胺素对血清乳酸和肌酐水平的影响,肾脏替代疗法的需要,ICU住院时间,选择ICU患者的死亡率。
方法:排除基于标题和摘要筛选的研究后,2名独立研究人员审查了其余文章的全文。下一步,第三名研究者解决了文章选择过程中的任何差异。
结果:在检索到的1628篇文章中,选择8个进行最终分析。这项研究表明,与安慰剂相比,补充硫胺素降低了血清肌酐水平(P=0.03)。此外,根据亚组分析,>60岁患者血清肌酐浓度明显降低(P<.00001)。然而,补充硫胺素组和安慰剂组的乳酸水平无统计学显著差异(P=.26).补充硫胺素并没有降低全因死亡率的风险(P=0.71)或肾脏替代疗法的需要(P=0.14)。符合条件的随机对照试验的汇总结果还表明,与安慰剂组相比,补充硫胺素并未减少ICU住院时间(P=0.39)。
结论:这项荟萃分析提供了证据,证明补充硫胺素对ICU患者的血肌酐升高具有保护作用。然而,需要进一步的高质量试验来发现补充硫胺素对ICU患者临床和生化结局的影响.
背景:PROSPEROno.CRD42023399710(https://www.crd.约克。AC.uk/prospro/display_record.php?RecordID=399710)。
BACKGROUND: The metabolic response to stress can deplete the remaining thiamine stores, leading to thiamine deficiency.
OBJECTIVE: 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).
METHODS: Scopus, PubMed, and Cochrane databases were searched to select studies up to 20 November 2022.
METHODS: 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.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: 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.
BACKGROUND: PROSPERO no. CRD42023399710 (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=399710).