Thiamine as a metabolic resuscitator after in-hospital cardiac arrest
- Enrolment stopped after 36 patients due to DSMB concern about potential harm in an unplanned subgroup analysis
Authors' conclusion
In this single center trial thiamine had no overall effect on lactate after in-hospital cardiac arrest.
Study context
- Population
- Adults after in-hospital cardiac arrest within 12 hours, mechanically ventilated, lactate ≥ 3 mmol/Lenrolment stopped early
- Participants
- 36 adults
- Comparison
- Thiamine vs placebo
- Primary endpoint
- Lactate (baseline, 6, 12, 24, 48 hours; linear mixed model for repeated measures)
- Follow-up
- 48 hours
Methodological detailsdouble-blind, placebo-controlled, phase II, single-centre, stratified by lactate
- Double-blind
- Placebo-controlled
- Phase II
- Single-centre
- Stratified by lactate
Primary result
As reported in the abstract
Lactate
No overall difference in lactate
mean difference at 48 hours 1.5 mmol/L [95% CI −3.1-6.1]
global p = 0.88
Secondary outcomes
Mortality, randomization lactate > 5 mmol/L (subgroup) · 11/12 vs 8/12 · unplanned subgroup analysis
P = 0.32
Mortality, randomization lactate ≤ 5 mmol/L (subgroup) · 1/6 vs 4/6
P = 0.24
- Mortality, randomization lactate ≤ 5 mmol/L (subgroup): interaction P (randomization lactate × thiamine effect on survival) p = 0.03
Oxygen consumption, pyruvate dehydrogenase, mortality
- No difference in any secondary outcome
Original publication
Thiamine as a metabolic resuscitator after in-hospital cardiac arrest. Resuscitation. Published 28 February 2024. doi:10.
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