Thiamine in septic shock patients with alcohol use disorders: An observational pilot study

Mathias Johan Holmberg, Ari Moskowitz, Parth Vijay Patel, Anne Victoria Grossestreuer, Amy Uber, Nikola Stankovic, Lars Wiuff Andersen, Michael William Donnino

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

Purpose Alcohol-use disorders (AUDs) have been associated with increased sepsis-related mortality. As patients with AUDs are often thiamine deficient, we investigated practice patterns relating to thiamine administration in patients with AUDs presenting with septic shock and explored the association between receipt of thiamine and mortality. Materials We performed a retrospective cohort study of patients presenting with septic shock between 2008 and 2014 at a single tertiary care center. We identified patients with an AUD diagnosis, orders for microbial cultures and use of antibiotics, vasopressor dependency, and lactate levels ≥ 4 mmol/L. We excluded those who received thiamine later than 48 h of sepsis onset. Results We included 53 patients. Thirty-four (64%) patients received thiamine. Five patients (15%) received their first thiamine dose in the emergency department. The median time to thiamine administration was 9 (quartiles: 4, 18) hours. The first thiamine dose was most often given parenterally (68%) and for 100 mg (88%). In those receiving thiamine, 15/34 (44%) died, compared to 15/19 (79%) of those not receiving thiamine, p = 0.02. Conclusions A considerable proportion of patients with AUDs admitted for septic shock do not receive thiamine. Thiamine administration in this patient population was associated with decreased mortality.

Original languageEnglish (US)
Pages (from-to)61-64
Number of pages4
JournalJournal of Critical Care
Volume43
DOIs
StatePublished - Feb 2018
Externally publishedYes

Keywords

  • Alcohol use disorder
  • EtOH
  • Sepsis
  • Septic shock
  • Thiamine
  • Vitamin B1

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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