Thiamine As An Adjuvant Therapy For Hyperlactatemia In Septic Shock Patients

Launched by UNIVERSITI KEBANGSAAN MALAYSIA MEDICAL CENTRE · Aug 23, 2018

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Introduction

Thiamine (Vitamin B1) is an essential component for cellular metabolism. It circulates in our body as free thiamine as well as active phosphorylated form - thiamine pyrophosphate (TPP). TPP acts as a co-factor for mitochondrial oxidative decarboxylation process and glycolytic pathway. In the deficient/ absence of thiamine, anaerobic metabolism occurs and causing lactate production with severe biochemical derangement.

Thiamine deficiency has shown to be more prevalent in critically ill patients, with rates ranging from 20 % to 70 % . The deficient might due to the lack of inta...

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Eligibility criteria

• Inclusion Criteria:
• • 1. Age ≥18 years old
• • 2. Septic shock patients 16 (Definition: Sepsis( presence of two or more q Sequential Organ Failure Assessment with documented/suspected infection) and hypotension requiring use of vasopressors to maintain MAP≥ 65 mmHg and having serum lactate ≥ 2 mmol/L despite adequate fluid resuscitation (\> 30mls/kg of crystalloid within the first 3 hours)
• Exclusion Criteria:
• • 1. Patients with a known allergy to the study drug.
• • 2. Pregnant patients
• • 3. Patients with limitation of therapy
• • 4. Patients with liver failure (include acute liver failure described as development of coagulopathy, international normalized ratio ( INR) of greater than 1.5, any degree of mental alteration( encephalopathy) in a patient without preexisting cirrhosis and with an illness of less than 26 weeks duration 17 or class C Child Pugh classification with the score of 10-15.18 )