Vitamin B12026

The association between thiamine use and mortality in critically ill patients with sepsis-associated acute respiratory failure: A retrospective analysis of the MIMIC-IV database.

Yin Ming, Suo Xingxing, Li Min, He Qian et al. — Respiratory medicine

Summary

A study investigated how vitamin B1 (thiamine) use affects critically ill patients suffering from severe lung problems caused by sepsis. It found that patients who received thiamine had a lower risk of dying in the hospital and intensive care unit, particularly those aged 65 and older. This suggests vitamin B1 might be a helpful additional treatment for these very sick patients.

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Key points

A study explored the link between vitamin B1 (thiamine) use and survival in very sick patients with sepsis-related lung failure.
Patients who received thiamine had a lower risk of death while in the hospital and intensive care unit.
This potential benefit of thiamine was most apparent in older patients, specifically those aged 65 and above.
These findings suggest vitamin B1 could be a helpful additional therapy, but more studies are needed.

What the study looked at

The study aimed to understand if giving thiamine (vitamin B1) to critically ill patients suffering from acute respiratory failure due to sepsis might affect their chances of survival. Sepsis is a severe response to infection, and acute respiratory failure means the lungs can't get enough oxygen into the blood. Researchers looked back at medical records from a large database (MIMIC-IV) covering over 6,200 patients admitted between 2008 and 2019. All these patients were critically ill with sepsis-associated acute respiratory failure. They compared patients who received thiamine supplementation to those who did not, carefully adjusting for other factors that could influence outcomes. The study found that patients who received thiamine had a lower risk of dying both in the hospital and in the intensive care unit compared to those who did not. This protective association was particularly strong for patients aged 65 and older. Younger patients did not show a significant link between thiamine use and mortality in this study.

Dietary takeaway

This study suggests that vitamin B1 (thiamine) might play a supportive role in very specific, severe medical conditions like sepsis-related acute respiratory failure, especially in older adults. For general healthy eating, ensuring adequate vitamin B1 intake through a balanced diet including whole grains, pork, and legumes is always beneficial for overall health. However, it's important to remember that this is one observational study, and more research, particularly randomized controlled trials, is needed before recommending thiamine supplementation as a standard treatment for this condition.

Abstract

BACKGROUND: Thiamine (vitamin B1) is a crucial cofactor in energy metabolism and antioxidant defense, yet its specific impact on patients with sepsis-associated acute respiratory failure remains unclear. METHODS: We conducted a retrospective cohort study of 6248 sepsis-associated acute respiratory failure patients in the MIMIC-IV database (2008-2019). Patients were categorized based on thiamine supplementation. The primary endpoints were in-hospital and ICU mortality, analyzed using Kaplan-Meier curves, multivariable Cox regression, propensity score matching (PSM), and subgroup analyses. RESULTS: The thiamine group comprised 1576 patients and the no-thiamine group 4672. After adjustment, the no thiamine group had a higher risk of hospital mortality (HR = 1.24, 95%CI 1.10-1.39) and ICU mortality (HR = 1.31, 95%CI 1.14-1.51). This protective association was confirmed in the PSM-matched cohort (n = 2784). Subgroup analysis indicated the benefit was most pronounced in patients aged ≥65 years, with no significant association observed in younger patients. CONCLUSION: Thiamine supplementation was independently associated with reduced in-hospital and ICU mortality in critically ill patients with sepsis-associated acute respiratory failure, particularly in the elderly.These findings support the need for randomized controlled trials to validate its potential as an adjunctive therapy.

View on PubMed →DOI: 10.1016/j.rmed.2026.108943