NCT03306732

Thiamine Supplementation in High Risk Cardiac Surgery Patients

• Status: Completed
• Phase: Phase 4
• Study type: Interventional
• Enrollment: 40 (actual)
• Sponsor: Meshalkin Research Institute of Pathology of Circulation · Network
• Sex: All
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

This pilot trial will evaluate the ability of thiamine to affect on postoperative vasoplegia in high risk cardiac surgery patients

Detailed description

Thiamine has a pivotal role and is an essential cofactor for pyruvate dehydrogenase activity. Widely known wet beri-beri is developed due to thiamine deficiency and characterized by vasodilatory shock and despaired oxygen extraction leading to kidney, heart and central nervous system dysfunction. Thiamine deficiency is often underestimated and even in primary absence of vitamin B1 deficiency, high-consumptive state of many critical illness and cardiac surgery itself can lead to its lack. Reported that in patients on chronic dialysis and patients with AKI requiring RRT thiamine deficiency is a usual finding. In cross-sectional observational study it has been shown that up to 33% of patients with a diagnosis of congestive heart failure (CHF) had thiamine deficiency due to chronic loop diuretic use. Also reported that 96% of patients (21 of 23) with heart failure receiving loop diuretic therapy (daily dose: 80-240 mg furosemide) developed thiamine deficiency. In prospective observational trial it has been shown that plasma thiamine levels were decreased after CABG surgery. In a secondary analysis of a randomized, double-blind, placebo-controlled trial conducted in septic patients, thiamine supplementation showed highly-promising renal protective effect. Need for RRT was 8 patients (21%) in placebo group and 1 patient (3%) in thiamine group (p=0.04). On the other hand it was unable to show any benefit of thiamine supplementation in patients undergoing CABG surgery. Although, postoperative oxygen consumption was significantly increased among patients receiving thiamine. Nevertheless, existing evidence suggests that thiamine supplementation might be an attractive strategy in counteracting organ dysfunction and thus morbidity and mortality in high-risk cardiac surgical patients.

Conditions

• Cardiac Surgery

Interventions

Type	Name	Description
DRUG	Thiamine hydrochloride (200mg) dissolved in 100 ml of normal saline	* After anesthesia induction * After separation from CPB * On the evening of the day of surgery (22:00) * On POD 1 twice a day at 8:00 and 22:00 * On POD 2 twice a day at 8:00 and 22:00 (if patient is still in ICU) * On POD 3 twice a day at 8:00 and 22:00 (if patient is still in ICU)
DRUG	Normal saline (100ml)	* After anesthesia induction * After separation from CPB * On the evening of the day of surgery (22:00) * On POD 1 twice a day at 8:00 and 22:00 * On POD 2 twice a day at 8:00 and 22:00 (if patient is still in ICU) * On POD 3 twice a day at 8:00 and 22:00 (if patient is still in ICU)

Timeline

• Start date: 2017-10-19
• Primary completion: 2018-05-18
• Completion: 2018-06-18
• First posted: 2017-10-11
• Last updated: 2018-06-27

Locations

1 site across 1 country: Russia