Related Experiment Video
Updated: Sep 22, 2025
Assessment of Intestinal Transcytosis of Neonatal Escherichia coli Bacteremia Isolates
Published on: February 17, 2023
Prevalence and Time Course of Thiamine Deficiency in Critically Ill Children: A Multicenter, Prospective Cohort Study
Emine Akkuzu1, Sinan Yavuz2, Serhan Ozcan3
1Department of Pediatrics, Division of Critical Care Medicine, Gazi University Hospital, Ankara, Turkey.
Insights
Thiamine deficiency (TD) affects 11.1% of pediatric intensive care unit (PICU) patients. Some patients improve, but a significant number develop TD during their PICU stay, highlighting a critical concern.
Area of Science:
- Critical care medicine
- Pediatric intensive care
- Nutritional deficiencies
Background:
- Thiamine deficiency (TD) is a critical concern in pediatric intensive care units (PICUs).
- Understanding the prevalence and temporal dynamics of TD is essential for patient management.
Purpose of the Study:
- To determine the prevalence and time course of thiamine deficiency (TD) in pediatric intensive care unit (PICU) patients.
- To assess the progression and resolution of TD during PICU admission.
Main Methods:
- A multicenter, prospective cohort study was conducted in three tertiary care PICUs in Turkey.
- 476 pediatric patients (1 month to 18 years) were analyzed for TD on days 1 and 3 of PICU admission.
- Exclusion criteria included absence of consent, inadequate samples, and recent vitamin supplementation, potentially introducing bias.
Main Results:
- On day 1, 11.1% (53/476) of patients had TD, with median thiamine levels of 65.5 ng/mL.
- On day 3, TD was present in 13.6% (27/199) of patients with repeated measurements.
- Of patients with TD on day 1, 52% improved, while 9% of initially TD-free patients developed TD by day 3.
Conclusions:
- The prevalence of thiamine deficiency (TD) in this PICU population was 11.1%.
- While some patients with TD improved, a notable percentage developed TD during their PICU stay.
- The development of TD during PICU admission is a significant concern requiring further investigation and management strategies.
Objectives:
To determine the prevalence and time course of thiamine deficiency (TD) in PICU patients.
Design:
Multicenter, prospective, cohort study between May 2019 and November 2019.
Setting:
Three university-based tertiary care, mixed medical-surgical PICUs in Ankara, Turkey.
Patients:
PICU patients 1 month to 18 years old.
Interventions:
None.
Measurements And Main Results:
We studied 476 patients and grouped them by TD status on days 1 and 3 of the PICU admission. There might be a risk of unintended bias since we excluded 386 patients because of the absence of consent, inadequate blood samples, loss of identifier information, and recent vitamin supplementation. On day 1, TD was present in 53 of 476 patients (11.1%) and median (minimum-maximum) thiamine levels were 65.5 ng/mL (5-431 ng/mL). On day 3, TD was present in 27 of 199 patients (13.6%) with repeated measurement. The median (minimum-maximum) thiamine levels were 63 ng/mL (13-357 ng/mL). The time course of TD from day 1 to day 3 in these 199 patients was as follows. In 21 of 199 patients (10.6%) with TD on day 1, 11 of 21 (52%) continued to have TD on day 3 and the other 10 of 21 patients (48%) improved to no longer having TD. In 178 of 199 patients (89.4%) without TD on day 1, 16 of 178 (9%) went on to develop TD by day 3, and the other 162 of 178 (91%) continued to have normal thiamine status.
Conclusions:
In the PICU population in three centers in Turkey, the prevalence of TD in the sample of patients was 11.1%. In those TD patients who had serial studies, we also identified that by day 3 some continued to be TD, and some patients improved to normal thiamine status. Of concern, however, is the population who develop TD over the course of PICU stay.
Related Concept Videos
01:30Vitamins
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:29Acute Kidney Injury III: Clinical Manifestations
01:29Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
01:22Acute Kidney Injury I: Introduction