Intravenous Thiamine and Outcomes in Septic Shock: A Retrospective Cohort Study

Objectives Thiamine deficiency is common among critically ill patients, and supplementation has been proposed to improve outcomes in septic shock. Evidence remains inconsistent. This study aimed to determine whether intravenous thiamine administration is associated with improved mortality, resolution of shock, or hemodynamic recovery in patients with septic shock. Results A retrospective observational study was conducted in a tertiary hospital in Palestine and included 200 adult ICU patients with septic shock (95 received intravenous thiamine and 105 served as controls). In-hospital mortality was 66.3% in the thiamine group versus 72.4% in the control group (adjusted OR 0.68, 95% CI 0.30–1.40). No significant difference was observed in 28-day mortality (adjusted OR 0.70, 95% CI 0.37–1.40) or shock resolution (adjusted HR 1.05, 95% CI 0.55–2.01). By day 3, a higher proportion of thiamine-treated patients were off norepinephrine (32.5% vs. 26.3%) and achieved ≥ 50% lactate reduction; however, both associations lost statistical significance after adjustment. Conclusion Further randomized studies are needed to clarify whether specific patient subgroups may benefit from thiamine in septic shock.