RATIONALE: Oxygen consumption may be impaired in critically ill patients. OBJECTIVES: To evaluate the effect of intravenous thiamine on oxygen consumption ([Formula: see text]o2) in critically ill patients. METHODS: This was a small, exploratory open-label pilot study conducted in the intensive care units at a tertiary care medical center. Critically ill adults requiring mechanical ventilation were screened for enrollment. Oxygen consumption ([Formula: see text]o2) and cardiac index (CI) were recorded continuously for 9 hours. After 3 hours of baseline data collection, 200 mg of intravenous thiamine was administered. The outcome was change in [Formula: see text]o2 after thiamine administration. MEASUREMENTS AND MAIN RESULTS:Twenty patients were enrolled and 3 were excluded because of incomplete [Formula: see text]o2 data, leaving 17 patients for analysis. There was a trend toward increase in [Formula: see text]o2 after thiamine administration (16.3 ml/min, SE 8.5; P = 0.052). After preplanned adjustment for changes in CI in case of a delivery-dependent state in some patients (with exclusion of one additional patient because of missing CI data), this became statistically significant (16.9 ml/min, SE 8.6; P = 0.047). In patients with average CI greater than our cohort's mean value of 3 L/min/m(2), [Formula: see text]o2 increased by 70.9 ml/min (±16; P < 0.0001) after thiamine. Thiamine had no effect in patients with reduced CI (< 2.4 L/min/m(2)). There was no association between initial thiamine level and change in [Formula: see text]o2 after thiamine administration. CONCLUSIONS: The administration of a single dose of thiamine was associated with a trend toward increase in [Formula: see text]o2 in critically ill patients. There was a significant increase in [Formula: see text]o2 in those patients with preserved or elevated CI. Further study is needed to better characterize the role of thiamine in oxygen extraction. Clinical trial registered with www.clinicaltrials.gov (NCT01462279).
RCT Entities:
RATIONALE: Oxygen consumption may be impaired in critically illpatients. OBJECTIVES: To evaluate the effect of intravenous thiamine on oxygen consumption ([Formula: see text]o2) in critically illpatients. METHODS: This was a small, exploratory open-label pilot study conducted in the intensive care units at a tertiary care medical center. Critically ill adults requiring mechanical ventilation were screened for enrollment. Oxygen consumption ([Formula: see text]o2) and cardiac index (CI) were recorded continuously for 9 hours. After 3 hours of baseline data collection, 200 mg of intravenous thiamine was administered. The outcome was change in [Formula: see text]o2 after thiamine administration. MEASUREMENTS AND MAIN RESULTS: Twenty patients were enrolled and 3 were excluded because of incomplete [Formula: see text]o2 data, leaving 17 patients for analysis. There was a trend toward increase in [Formula: see text]o2 after thiamine administration (16.3 ml/min, SE 8.5; P = 0.052). After preplanned adjustment for changes in CI in case of a delivery-dependent state in some patients (with exclusion of one additional patient because of missing CI data), this became statistically significant (16.9 ml/min, SE 8.6; P = 0.047). In patients with average CI greater than our cohort's mean value of 3 L/min/m(2), [Formula: see text]o2 increased by 70.9 ml/min (±16; P < 0.0001) after thiamine. Thiamine had no effect in patients with reduced CI (< 2.4 L/min/m(2)). There was no association between initial thiamine level and change in [Formula: see text]o2 after thiamine administration. CONCLUSIONS: The administration of a single dose of thiamine was associated with a trend toward increase in [Formula: see text]o2 in critically illpatients. There was a significant increase in [Formula: see text]o2 in those patients with preserved or elevated CI. Further study is needed to better characterize the role of thiamine in oxygen extraction. Clinical trial registered with www.clinicaltrials.gov (NCT01462279).
Authors: Michael W Donnino; Erin Carney; Michael N Cocchi; Ian Barbash; Maureen Chase; Nina Joyce; Peter P Chou; Long Ngo Journal: J Crit Care Date: 2010-06-19 Impact factor: 3.425
Authors: Michael W Donnino; Michael N Cocchi; Howard Smithline; Erin Carney; Peter P Chou; Justin Salciccioli; Justin Salciccoli Journal: Nutrition Date: 2010-01 Impact factor: 4.008
Authors: Lars W Andersen; Mathias J Holmberg; Katherine M Berg; Maureen Chase; Michael N Cocchi; Christopher Sulmonte; Julia Balkema; Mary MacDonald; Sophia Montissol; Venkatachalam Senthilnathan; David Liu; Kamal Khabbaz; Adam Lerner; Victor Novack; Xiaowen Liu; Michael W Donnino Journal: Crit Care Date: 2016-03-14 Impact factor: 9.097