Other micronutrients such as vitamin C and D, selenium and zinc have been tested in the same context but have not been shown to improve the outcomes of these patients. However, there is no evident improvement in the survival of septic patients. Thiamine deficiency could affect up to 70% of critically ill patients, and thiamine supplementation appears to increase lactate clearance and decrease the vasopressor dose. Thiamine, also known as vitamin B1, plays critical roles in several biological processes, including the metabolism of glucose, synthesis of nucleic acids and reduction of oxidative stress. Considering that metabolic changes, mitochondrial dysfunction and increased oxidative stress are specific disorders within the path of septic shock, several micronutrients that could act in cellular homeostasis have been studied in recent decades. New adjunctive therapies have been explored to reduce global mortality related to sepsis. Septic shock is associated with unacceptably high mortality rates, mainly in developing countries. 2Department of Internal Medicine, Botucatu Medical School, São Paulo State University (UNESP), Botucatu, Brazil.1Faculty of Nutrition, Universidade Federal de Goiás (UFG), Goiânia, Brazil.Nara Aline Costa 1 Amanda Gomes Pereira 2 Clara Sandra Araujo Sugizaki 1 Nayane Maria Vieira 2 Leonardo Rufino Garcia 2 Sérgio Alberto Rupp de Paiva 2 Leonardo Antonio Mamede Zornoff 2 Paula Schmidt Azevedo 2 Bertha Furlan Polegato 2 Marcos Ferreira Minicucci 2 *
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