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首页> 外文期刊>Journal of critical care >Thiamine in septic shock patients with alcohol use disorders: An observational pilot study
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Thiamine in septic shock patients with alcohol use disorders: An observational pilot study

机译：硫胺素在脓毒症休克患者患有酒精使用障碍：观察试点研究

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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 levelse4mmol/L. We excluded those who received thiamine later than 48h 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 100mg (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. Highlights " Many patients with alcohol-use-disorders and septic shock do not receive thiamine. " Thiamine was most often given in the ICU, rather than the emergency department. " Failure to receive thiamine may be associated with increased mortality.
机译：摘要目的饮酒障碍（AUDS）已与败血症相关的死亡率增加有关。由于患有患者的患者通常是硫胺素缺乏，我们调查了与硫胺素管理有关的实践模式，患有脓毒症休克患者的患者，并探讨了硫胺素和死亡率之间的关联。材料我们在单个第三级护理中心进行了2008年至2014年患者患者的回顾性队列研究。我们鉴定了患有AUD诊断的患者，微生物培养订单和抗生素的使用，血管加压效应依赖性和乳酸乳液培养型4mmol / L。我们排除了晚些时候在败血症发病的48小时后获得硫胺素的人。结果我们包括53名患者。三十四（64％）患者接受硫胺素。五名患者（15％）在急诊部门获得了第一份硫胺素剂量。硫胺素给药的中位时间为9（四分位数：4,18）小时。第一个硫胺素剂量最常被肠胃直接（68％）和100mg（88％）。在接受硫胺素的那些中，15/34（44％）死亡，而未接受硫胺素的15/19（79％），P = 0.02。结论患病患者患有相当大比例的患者，不接受脓毒症休克不会收到硫胺素。本患者群体的硫胺素管理与死亡率下降有关。亮点“许多患有酒精使用障碍和脓毒症休克的患者不接受硫胺素。”硫胺素最常见于ICU，而不是急诊部门。 “未能接受硫胺素可能与死亡率增加相关。

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