Comparison of the effectiveness of thiamine in combination with Vitamin C and its combination with glutamine on survival outcome in intensive care unit patients: A randomized controlled trial

Background and Aims: The roles of thiamine, Vitamin C, and glutamine in improving the clinical outcomes of patients admitted to the intensive care unit (ICU) have been recommended. However, there is no trial that compared the effect of the combination of these nutrients in the ICU. The primary objective of this study was to compare the effects of thiamine in combination with Vitamin C and its combination with glutamine on the survival of critically ill patients admitted to the ICU. The secondary objectives were duration of ICU stay, effects on Sequential Organ Failure Assessment (SOFA) score, and number of free days of ventilation. Methods: This randomized controlled study was conducted on 90 critically ill patients aged 18–65 years, of either gender, for over 24 h with a minimum SOFA score of 2. Patients were divided into two groups – group TC and group TG (thiamine – 2 mg/kg intravenously, Vitamin C – 1 g twice daily IV, glutamine – 0.5 g/kg/day intravenously). Results: Twenty-nine patients survived in group TC, whereas 17 survived in group TG ( P = 0.02). There was a significantly longer duration of ICU stay ( P value-0.01) and ventilator-free days ( P = 0.023) in group TC. The change in SOFA score in group TC was significant ( P = 0.036), whereas it was not significant in group TG. No side effect of any study drug was observed at any time point. Conclusion: Thiamine with Vitamin C supplementation improves the survival outcome of ICU patients.