(912) Safety Evaluation of Thiamine 500 mg Intravenous Push Administration Among Critically Ill Patients

Introduction: There is limited data pertaining to the safety of administering thiamine 500 mg via intravenous (IV) push. The purpose of this evaluation was to compare the safety of administering thiamine 500 mg via IV push versus IV infusion among critically ill patients.

Methods: This was a retrospective, quasi-experimental, pre- and post-intervention analysis comparing the safety of IV thiamine 500 mg before and after changing standard administration practices from an IV infusion to IV push. Patients admitted to an intensive care unit (ICU) were included if they received at least 3 doses of IV thiamine 500 mg. The primary outcome was the incidence of any adverse reaction. Secondary outcomes included hypotension, injection site reactions, angioedema, anaphylaxis, and medication safety events reported. Categorical data were compared using a Chi-squared test, and continuous data were compared using a Student’s t-test.

Results: There were 102 patients included in the analysis, of which 51 received thiamine via IV infusion and 51 via IV push. A total of 407 doses were given via IV infusion, and 441 via IV push. Adverse reactions were documented in 19 patients in the IV infusion group (37.3%) and in 24 patients in the IV push group (47.1%) (p=0.316). The most common adverse reaction was hypotension, which occurred in 16 patients in the IV infusion group (31.4%) and in 23 patients in the IV push group (45.1%) (p=0.154). There were 3 cases of phlebitis in the IV infusion group (5.9%) and 4 cases of phlebitis in the IV push group (7.8%) (p=0.773). Only 1 case of infiltration was documented which occurred in the IV push group (p=0.315). There were no cases of angioedema or anaphylaxis.

Conclusions: Administration of thiamine 500 mg via IV push was not associated with any statistically significant differences in overall adverse events. There were no serious adverse reactions, including anaphylaxis. The present study demonstrated that thiamine 500 mg IV push is associated with similar rates of adverse events compared with IV infusion among critically ill adults.