What does this research mean for the field?

Empiric thiamine supplementation should be administered to high-risk critically ill patients in the ICU to prevent or treat deficiency-induced organ dysfunction, as diagnostic assays are impractical and supplementation is safe and inexpensive. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To review the pathophysiology, clinical consequences, and diagnostic challenges of thiamine deficiency in intensive care patients, and to evaluate the rationale for empiric thiamine supplementation.

September 3, 2026Critical CareOpen Access

Thiamine-deficiency in the ICU-patient - When the plug is out

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Authors

WDWilfred Druml TSThomas Staudinger GEGunnar Elke

Discussion

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Overview

Clinical review highlights improved organ function and reduced mortality with thiamine supplementation in critically ill patients, supporting empiric administration in high-risk groups.

Key Points

To review the pathophysiology, clinical consequences, and diagnostic challenges of thiamine deficiency in intensive care patients, and to evaluate the rationale for empiric thiamine supplementation.
Examined cellular mechanisms linking thiamine depletion to mitochondrial energy failure, accelerated lactate generation, and impaired lactate clearance.
Evaluated the diagnostic limitations of plasma thiamine assays alongside high-risk clinical profiles in critically ill populations.
Thiamine deficiency precipitates multiorgan dysfunction involving the neurological, cardiovascular, and renal systems while significantly worsening patient prognosis.
Empirical thiamine supplementation safely improves organ function, accelerates blood lactate clearance, and reduces mortality in vulnerable patient groups without risk of toxicity.

Cite This Study

Druml et al. (2026) studied this question.

synapsesocial.com/papers/6a993653636c6408cfa7f5e7 https://doi.org/10.1186/s13054-026-06299-w

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September 3, 2026Critical CareOpen Access

Thiamine-deficiency in the ICU-patient - When the plug is out

View Full Paper

Ask AI

Bookmark

Authors

WDWilfred Druml TSThomas Staudinger GEGunnar Elke

Discussion

Member takes

Overview

Clinical review highlights improved organ function and reduced mortality with thiamine supplementation in critically ill patients, supporting empiric administration in high-risk groups.

Key Points

To review the pathophysiology, clinical consequences, and diagnostic challenges of thiamine deficiency in intensive care patients, and to evaluate the rationale for empiric thiamine supplementation.
Examined cellular mechanisms linking thiamine depletion to mitochondrial energy failure, accelerated lactate generation, and impaired lactate clearance.
Evaluated the diagnostic limitations of plasma thiamine assays alongside high-risk clinical profiles in critically ill populations.
Thiamine deficiency precipitates multiorgan dysfunction involving the neurological, cardiovascular, and renal systems while significantly worsening patient prognosis.
Empirical thiamine supplementation safely improves organ function, accelerates blood lactate clearance, and reduces mortality in vulnerable patient groups without risk of toxicity.

Cite This Study

Druml et al. (2026) studied this question.

synapsesocial.com/papers/6a993653636c6408cfa7f5e7 https://doi.org/10.1186/s13054-026-06299-w

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