Normal Saline 50 mls infused over 1 hour 3 times per day for total 3 days for placebo group after recruitment and randomization done.
If patients develop rashes or redness after normal saline administration, IV hydrocortisone (corticosteroid) 200mg stat dose will be given.

IV Thiamine 200mg diluted in 50mls normal saline infused over 1 hour 3 times per day for total 3 days for Thiamine group after recruitment and randomization done.
If patients develop nausea after thiamine administration, IV metoclopramide (antiemetic)10mg stat dose will be given. If patients develop redness and rashes after Normal Saline infusion, IV hydrocortisone (corticosteroid) 200mg stat dose will be given.

Hyperlactatemia

Normal Saline 50 mls infused over 1 hour 3 times per day for total 3 days after recruitment and randomization.

Normal Saline

IV Thiamine 200 mg diluted in 50 mls normal saline infused over 1 hour 3 times per day for total 3 days after recruitment and randomization

Thiamine

If patient develop redness or rashes after normal saline infusion, IV hydrocortisone 200 mg stat will be given

Hydrocortisone

If patient develop nausea after IV thiamine infusion, IV metoclopramide 10mg stat will be given. If patient develop redness or rashes after normal saline infusion, IV hydrocortisone 200 mg stat will be given.

Metoclopramide

Universiti Kebangsaan Malaysia Medical Centre

Thiamine As An Adjuvant Therapy For Hyperlactatemia In Septic Shock Patients

Thiamine As An Adjuvant Therapy For Hyperlactatemia In Septic Shock Patients: A Prospective Randomized Study

To assess the relative lactate level change from baseline to 24 hours after the initiation of the study drugs (defined as (lactate at 0 hour-lactate at 24 hours)/lactate at 0 hour x100%).
Arterial blood sample for lactate will be collected in a heparinised blood-gas syringe by trained ICU staff nurse at enrolment (time 0) before commencing study drug, and 24 hours after the study drug administration. A blood lactate sample will be analyzed by using a blood gas analyzer in ICU (ABL 800 Basic, Radiometer Medical ApS, Denmark).

Assessment of the duration used for weaning off the vasopressors in hours. It will be calculated from the date and time of the inotropes started until the date and time of the inotropes stopped

To assess APACHE (Acute physiology and Chronic Health Evaluation) II score to predict the patient mortality. APACHE II score consists of 12 variables with maximum score of 72. The higher the score, the higher the risk of patient's mortality.

After patient was recruited, patient will be assessed the total length of stay in ICU in terms of days

To assess SOFA (sequential organ failure assessment) score to predict patient's mortality risk. The higher the score, the higher the mortality risk.
SOFA score is based of the degree of 6 organ dysfunction with maximum score of 24.
Assessment will recorded from the time 0 (after recruitment and randomization) and at 24 hours, 48 hours, and 72 hours.

To assess the rate of the lactate change over 72 hours after study drug administration.

This study is a prospective, randomized controlled trial

This study is a single-blinded trial, with the participants from both intervention and placebo group will be masked

Pregnant women until 12 week of gestation who refer to the ER because of nausea and vomiting and didn't improve after hydration, will receive thiamine IV

Pregnant women until 12 week of gestation who refer to the ER because of nausea and vomiting and didn't improve after hydration, will receive promethazine IV

thiamine/pahoinvointi

Thiamine As An Adjuvant Therapy For Hyperlactatemia In Septic Shock Patients

Does Thiamine Help Vomiting and Nausea in Pregnancy?

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