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Effect of blood thiamine concentrations on mortality: Influence of nutritional status

Heitor Pons Leite1, Lúcio Flávio Peixoto de Lima2, José Augusto de A C Taddei1

  • 1Discipline of Nutrition and Metabolism, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil.

Nutrition (Burbank, Los Angeles County, Calif.)
|February 23, 2018
PubMed

Insights

Low blood thiamine levels increase mortality risk in critically ill children. However, thiamine appears protective against 30-day mortality in malnourished children, suggesting a targeted intervention.

Area of Science:

  • Pediatric Critical Care Medicine
  • Nutritional Biochemistry
  • Clinical Research

Background:

  • Malnourished critically ill children face high mortality risks.
  • Thiamine (vitamin B1) deficiency is a concern in this population.
  • The direct impact of thiamine levels on mortality in these children requires clarification.

Purpose of the Study:

  • To investigate the association between blood thiamine concentrations and 30-day mortality in critically ill children.
  • To determine if malnutrition modifies the relationship between thiamine levels and mortality.

Main Methods:

  • A prospective cohort study involving 202 critically ill children.
  • Blood thiamine concentrations were measured on admission and days 5 and 10 of intensive care unit (ICU) stay.
  • Statistical analysis examined the relationship between thiamine levels, malnutrition, and 30-day mortality, adjusting for other clinical factors.

Main Results:

  • Thiamine deficiency was identified in 61 patients within the first 10 days of ICU care.
  • Lower blood thiamine concentrations were independently associated with higher C-reactive protein levels.
  • A significant interaction was found between mean blood thiamine and malnutrition regarding 30-day mortality risk (P=0.002).

Conclusions:

  • Mean blood thiamine concentration showed a protective effect against 30-day mortality in malnourished critically ill children (OR=0.85, P=0.029).
  • No significant effect of blood thiamine concentration on mortality was observed in well-nourished patients (OR=1.03, P=0.46).
  • These findings suggest that thiamine may play a protective role in malnourished critically ill children.
Abstract

Keywords:
Critical care outcomesCritical illnessIntensive care units, pediatricMalnutritionNutritional statusThiamine

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