Thiamine (Vitamin B1) Deficiency in Intensive Care: Physiology, Risk Factors, Diagnosis, and Treatment

  • Heitor Pons Leite
  • Lúcio Flávio Peixoto de Lima
Reference work entry


Thiamine plays an essential role in cellular energy metabolism; its deficiency will result in severely compromised energy generation and may culminate in cellular dysfunction and death. Body stores of thiamine are small and deficiency can develop within 2–3 weeks of inadequate intake. Systemic inflammation, increased renal or gastrointestinal losses, increased water turnover, and insufficient supply are the most common risk factors for thiamine deficiency in critically ill patients.

Thiamine deficiency affects the central and peripheral nervous system and cardiovascular system in different combinations. Considering that early diagnosis and treatment are crucial to prevent sequelae and severe deficiency may be potentially fatal, treatment should be initiated at the very earliest suspicion of vitamin depletion – laboratory confirmation is not required to initiate supplementation in high-risk patients. Treatment is cheap, easy, and safe. The dose, route, and extent of treatment will depend on the clinical condition and severity of the deficiency.


Lactic Acidosis CRRTContinuous Renal Replacement Therapy Thiamine Deficiency Thiamine Pyrophosphate Thiamine Concentration 
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List of Abbreviations


α-ketoglutarate dehydrogenase


Branched-chain keto acid dehydrogenase


Continuous renal replacement therapy


Erythrocyte transketolase activity


Gamma-aminobutyric acid


High-performance liquid chromatography


Pyruvate dehydrogenase


Thiamine deficiency


Thiamine diphosphate


Thiamine pyrophosphate


Thiamine pyrophosphate effect


Wernicke’s encephalopathy


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Heitor Pons Leite
    • 1
  • Lúcio Flávio Peixoto de Lima
    • 2
  1. 1.Discipline of Nutrition and Metabolism, Department of PediatricsFederal University of Sao PauloSao PauloBrazil
  2. 2.Pediatric Intensive Care Unit, Department of PediatricsFederal University of São PauloSão PauloBrazil

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