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Thiamine deficiency in the critically ill.

A M Cruickshank1, A B Telfer, A Shenkin

  • 1Department of Biochemistry, Royal Infirmary, Glasgow, UK.

Intensive Care Medicine
|January 1, 1988
PubMed
Summary
This summary is machine-generated.

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Critically ill patients often have low thiamine levels, increasing mortality risk. Supplementation may need adjustment, with a suggested loading dose for intensive care unit (ICU) admissions.

Area of Science:

  • Clinical Nutrition
  • Critical Care Medicine
  • Biochemistry

Background:

  • Growing concern regarding clinical thiamine deficiency in hospitalized patients.
  • Ongoing debate on optimal thiamine supplementation for patients receiving parenteral nutrition, especially in intensive care settings.

Purpose of the Study:

  • To investigate the association between thiamine status and patient outcomes in the intensive care unit (ICU).
  • To evaluate the adequacy of current thiamine supplementation protocols for critically ill, intravenously fed patients.

Main Methods:

  • Retrospective study involving 158 patients admitted to the ICU requiring nutritional support.
  • Assessment of body thiamine status and serum albumin concentrations.
  • Analysis of mortality rates in relation to thiamine deficiency.

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Main Results:

  • Survivors exhibited significantly higher body thiamine status compared to non-survivors (p < 0.01).
  • No significant difference in serum albumin levels between survivors and non-survivors.
  • Twenty percent of patients showed biochemical evidence of thiamine deficiency, with a 72% mortality rate in this subgroup versus 50% overall mortality.

Conclusions:

  • Biochemical thiamine deficiency is linked to increased mortality in critically ill patients.
  • Current thiamine supplementation levels appear insufficient for intravenously fed ICU patients.
  • A loading dose of 50-250 mg of thiamine upon ICU admission is proposed.