At least, when you’re thiamine deficient.
Of the magic cocktail of profound improvement in sepsis, it is not known the relative importance of the various ingredients, whether it is a synergistic effect, or, technically, whether the treatment is real or artifactual. Thiamine deficiency, however, is frequently detected in patients with sepsis and septic shock. A small pilot study showed no overall effect of thiamine administration to a general population with sepsis, but a subgroup with documented thiamine deficiency suggested improvements in lactate clearance and mortality.
Following up these findings, these authors performed a retrospective review of outcomes of patients admitted to their single center with sepsis and septic shock, as defined by a lactate greater than 2 mmol/L and a need for vasopressors. They created two matched cohorts using Mahalanobis distance, and, lo: lactate clearance was improved with thiamine, as was overall mortality, with a Hazard ratio of 0.666 (95% CI, 0.490-0.905).
This is, again, retrospective data and statistical tomfoolery to match. But, it is consistent, at least, with other prospective and observational data. It seems quite reasonable to evaluate patients with septic shock for thiamine deficiency, with the expectation supplementation may improve outcomes.
“Effect of Thiamine Administration on Lactate Clearance and Mortality in Patients With Septic Shock”
Effect of thiamine