Effect of Thiamine on Serum Glucagon And Reactive Oxygen Species (ROS)

NCT ID: NCT05663164

Last Updated: 2022-12-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-10-01

Study Completion Date

2022-12-01

Brief Summary

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This research is a clinical trial with a Randomized Controlled Trial (RCT) design. The purpose is to identify the effect of intravenous thiamine administration compared to normal saline placebo on glucagon levels and ROS levels in patients undergoing general anesthesia surgery

Detailed Description

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Surgery may increase postoperative cortisol and blood glucose levels. Changes in normal metabolic patterns due to surgery stimulate gluconeogenesis, glycogenolysis, proteolysis, lipolysis, and cytogenesis. These result in hyperglycemia and ketosis conditions. Surgery and anesthesia lead to an immunosuppressive effect. Increased secretion of proinflammatory cytokines may also occur after the surgery.

Besides an increase in cortisol levels, surgery can also increase cytokine response and ROS production in patients who have undergone surgery under general anesthesia after 72 hours. ROS production can also be a useful indicator in assessing the severity of surgical trauma.

In surgical procedures, there is an acute increase in reactive oxidative stress (ROS). This occurs when ischemia is followed by reperfusion. ROS can trigger tissue injury seen in transplantation (liver and heart), the release of aortic clamps during abdominal and thoracic aortic surgery, the release of limb tourniquets during orthopedic surgery, and reperfusion during and after cardiopulmonary bypass. There is a thiamine deficiency in 20% of patients treated in the intensive care unit (ICU). Thiamine deficiency is a source of lactic acidosis that does not seem in severe sepsis and septic shock. An imbalance between the formation and removal of free radicals causes a pathological condition called oxidative stress. However, the human body uses antioxidants to suppress these free radicals. One of the antioxidants that can reduce oxidative stress is thiamine. Previous studies proved this finding. Thiamine has also been able to significantly prevent the expression of inflammatory cytokines and chemokines, depending on NF-B induced by thromboxane and PGI2 synthase.

Conditions

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Sepsis Thiamine Deficiency

Keywords

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thiamine sepsis glucagon ROS Perioperative Stress Response

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Experimental: Vitamin B1

Vitamin B1 (thiamine) 100mg every 6 hours x 3-days

Group Type EXPERIMENTAL

Vitamin B

Intervention Type DRUG

vitamin B1 (100mg) will be diluted in 50 ml 0.9% NACL(normal saline) and administered IV every 6 hours for 3 days

Drug: Normal saline

Normal saline (0.9% NaCl solution) volume to match all components

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Normal saline (0.9% NaCl solution) volume to match all components

Interventions

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Vitamin B

vitamin B1 (100mg) will be diluted in 50 ml 0.9% NACL(normal saline) and administered IV every 6 hours for 3 days

Intervention Type DRUG

Placebo

Normal saline (0.9% NaCl solution) volume to match all components

Intervention Type DRUG

Other Intervention Names

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Thiamine Normal saline

Eligibility Criteria

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Inclusion Criteria

* Patients aged 18-65 years who undergo surgery under general anesthesia
* ASA physical statuses 1 and 2
* Sepsis

Exclusion Criteria

* Refuse to participate
* Diabetes mellitus, experience shock sepsis or lactic acidosis
* Have a history of hypersensitivity (allergy) to thiamine
* Thiamine deficiency
* Take immunomodulatory drugs, antiplatelet or anticoagulants surgery duration \> 6 hours, and thiamin regularly
* They experience massive bleeding and receive blood transfusions preoperatively, intraoperatively, or postoperatively
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Universitas Sumatera Utara

OTHER

Sponsor Role lead

Responsible Party

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Bastian Lubis

Head of Intensive Care Unit

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Bastian Lubis, Dr

Role: PRINCIPAL_INVESTIGATOR

Faculty of Medicine Universitas Sumatera Utara

Locations

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Faculty of Medicine Universitas Sumatera Utara

Medan, North Sumatra, Indonesia

Site Status

Countries

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Indonesia

References

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Cusack B, Buggy DJ. Anaesthesia, analgesia, and the surgical stress response. BJA Educ. 2020 Sep;20(9):321-328. doi: 10.1016/j.bjae.2020.04.006. Epub 2020 Jul 21. No abstract available.

Reference Type BACKGROUND
PMID: 33456967 (View on PubMed)

Prete A, Yan Q, Al-Tarrah K, Akturk HK, Prokop LJ, Alahdab F, Foster MA, Lord JM, Karavitaki N, Wass JA, Murad MH, Arlt W, Bancos I. The cortisol stress response induced by surgery: A systematic review and meta-analysis. Clin Endocrinol (Oxf). 2018 Nov;89(5):554-567. doi: 10.1111/cen.13820. Epub 2018 Aug 23.

Reference Type BACKGROUND
PMID: 30047158 (View on PubMed)

Davis G, Fayfman M, Reyes-Umpierrez D, Hafeez S, Pasquel FJ, Vellanki P, Haw JS, Peng L, Jacobs S, Umpierrez GE. Stress hyperglycemia in general surgery: Why should we care? J Diabetes Complications. 2018 Mar;32(3):305-309. doi: 10.1016/j.jdiacomp.2017.11.010. Epub 2017 Nov 29.

Reference Type BACKGROUND
PMID: 29273446 (View on PubMed)

Sudhakaran S, Surani SR. Guidelines for Perioperative Management of the Diabetic Patient. Surg Res Pract. 2015;2015:284063. doi: 10.1155/2015/284063. Epub 2015 May 19.

Reference Type BACKGROUND
PMID: 26078998 (View on PubMed)

Hazell AS, Faim S, Wertheimer G, Silva VR, Marques CS. The impact of oxidative stress in thiamine deficiency: a multifactorial targeting issue. Neurochem Int. 2013 Apr;62(5):796-802. doi: 10.1016/j.neuint.2013.01.009. Epub 2013 Jan 18.

Reference Type BACKGROUND
PMID: 23333339 (View on PubMed)

Costa NA, Gut AL, de Souza Dorna M, Pimentel JA, Cozzolino SM, Azevedo PS, Fernandes AA, Zornoff LA, de Paiva SA, Minicucci MF. Corrigendum to "serum thiamine concentration and oxidative stress as predictors of mortality in patients with septic shock" [J Crit care 2014;29(2):249-52]. J Crit Care. 2016 Dec;36:311. doi: 10.1016/j.jcrc.2016.07.001. Epub 2016 Jul 10. No abstract available.

Reference Type BACKGROUND
PMID: 27810062 (View on PubMed)

Luong KV, Nguyen LT. The impact of thiamine treatment in the diabetes mellitus. J Clin Med Res. 2012 Jun;4(3):153-60. doi: 10.4021/jocmr890w. Epub 2012 May 15.

Reference Type BACKGROUND
PMID: 22719800 (View on PubMed)

Karkabounas S, Papadopoulos N, Anastasiadou C, Gubili C, Peschos D, Daskalou T, Fikioris N, Simos YV, Kontargiris E, Gianakopoulos X, Ragos V, Chatzidimitriou M. Effects of alpha-Lipoic Acid, Carnosine, and Thiamine Supplementation in Obese Patients with Type 2 Diabetes Mellitus: A Randomized, Double-Blind Study. J Med Food. 2018 Dec;21(12):1197-1203. doi: 10.1089/jmf.2018.0007. Epub 2018 Oct 11.

Reference Type BACKGROUND
PMID: 30311825 (View on PubMed)

Lubis B, Lelo A, Amelia P, Prima A. The Effect of Thiamine, Ascorbic Acid, and the Combination of Them on the Levels of Matrix Metalloproteinase-9 (MMP-9) and Tissue Inhibitor of Matrix Metalloproteinase-1 (TIMP-1) in Sepsis Patients. Infect Drug Resist. 2022 Sep 30;15:5741-5751. doi: 10.2147/IDR.S378523. eCollection 2022.

Reference Type BACKGROUND
PMID: 36204393 (View on PubMed)

Other Identifiers

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Interventional

Identifier Type: -

Identifier Source: org_study_id