EFICÁCIA DA SUPLEMENTAÇÃO DE TIAMINA EM PACIENTES COM SEPSE: REVISÃO SISTEMÁTICA DE ESTUDOS CLÍNICOS
DOI:
https://doi.org/10.56238/arev8n5-075Palavras-chave:
Sepse, Choque Séptico, Tiamina, Vitamina B1, Terapia IntensivaResumo
Introdução: A sepse e o choque séptico permanecem associados a elevada morbimortalidade, apesar dos avanços no diagnóstico e no suporte intensivo. A tiamina tem sido investigada como terapia adjuvante por seu papel no metabolismo energético celular e na redução da acidose láctica. Objetivo: Avaliar a efetividade da suplementação de tiamina, isolada ou em combinação com o uso da vitamina C e da hidrocortisona, em pacientes adultos com sepse ou em choque séptico. Métodos: Uma revisão sistemática conduzida conforme o PRISMA 2020, com busca nas bases de dados como: PubMed/MEDLINE e LILACS para estudos publicados no período entre 2015 à 2025. Foram incluídos ensaios clínicos randomizados, ensaios não randomizados e estudos observacionais comparativos com pacientes adultos sépticos tratados com tiamina intravenosa, isolada ou combinada, comparados ao tratamento padrão ou placebo. Resultados: O presente estudo incluiu 29 artigos cientificos. Os ensaios que avaliaram a terapia combinada HAT não demonstraram benefício consistente sobre mortalidade, escore SOFA ou tempo livre de vasopressores. Em contrapartida, estudos com tiamina isolada ou análises de subgrupos sugeriram benefício em pacientes com deficiência basal de tiamina, com melhora de lactato, função renal e sobrevida livre de terapia renal substitutiva. Conclusão: A suplementação de tiamina apresenta perfil de segurança favorável, mas sem benefício clínico global consistente na população em geral, sob o quadro clinico de sepse ou choque séptico. Observou-se, que seu uso pode ser mais promissor em subgrupos metabolicamente vulneráveis, especialmente pacientes com deficiência prévia de tiamina, quando comparado com os demais pacientes.
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Referências
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