John is a 62-year-old male admitted to the ICU after experiencing an in-hospital cardiac arrest 8 hours ago. He is mechanically ventilated and has a baseline lactate level of 6.2 mmol/L. His medical history includes hypertension and type 2 diabetes. Current medications include metoprolol 50 mg daily and insulin glargine. The ICU team is considering adjunctive therapies to improve his metabolic status.

Based on the recent evidence from Berg et al. (2024), what is the most appropriate pharmacist recommendation regarding intravenous thiamine administration in John’s case?

Emily is a 55-year-old female who suffered an in-hospital cardiac arrest 10 hours ago. She is mechanically ventilated with a baseline lactate of 4.8 mmol/L. The ICU team is reviewing recent literature on thiamine use post-cardiac arrest and asks for your input on interpreting subgroup findings from recent trials.

How should a pharmacist interpret the unplanned subgroup analysis from Berg et al. (2024) regarding thiamine’s effect on mortality based on baseline lactate levels?

Michael, a 70-year-old male, was admitted after an in-hospital cardiac arrest 6 hours ago. He is mechanically ventilated with a lactate level of 3.5 mmol/L. The ICU team requests pharmacist input on adjunctive therapies to improve metabolic recovery and reduce lactate levels.

Considering the current evidence from Berg et al. (2024), what is the best pharmacist advice regarding adjunctive metabolic therapies in this patient?