Journal article

A multicenter randomized clinical trial of pharmacological vitamin B1 administration to critically ill patients who develop hypophosphatemia during enteral nutrition (The THIAMINE 4 HYPOPHOSPHATEMIA trial)

Adam M Deane, Alice Jiang, Brianna Tascone, Annabelle Clancy, Mark E Finnis, Jake T Collie, Ronda Greaves, Kathleen M Byrne, Tomoko Fujii, James S Douglas, Alistair Nichol, Andrew A Udy, Meredith Young, Giovanni Russo, Kate Fetterplace, Matthew J Maiden, Mark P Plummer, Fumitaka Yanase, Rinaldo Bellomo, Yasmine Ali Abdelhamid



BACKGROUND: Hypophosphatemia may be a useful biomarker to identify thiamine deficiency in critically ill enterally-fed patients. The objective was to determine whether intravenous thiamine affects blood lactate, biochemical and clinical outcomes in this group. METHOD: This randomized clinical trial was conducted across 5 Intensive Care Units. Ninety critically ill adult patients with a serum phosphate ≤0.65 mmol/L within 72 h of commencing enteral nutrition were randomized to intravenous thiamine (200 mg every 12 h for up to 14 doses) or usual care (control). The primary outcome was blood lactate over time and data are median [IQR] unless specified. RESULTS: Baseline variables were well bala..

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Funding Acknowledgements

The trial was supported by a Royal Melbourne Hospital Grant in Aid. AMD was supported by a NHMRC Career Development Fellowship.