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

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

Abstract

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.

Keywords

Lactic Acidosis CRRTContinuous Renal Replacement Therapy Thiamine Deficiency Thiamine Pyrophosphate Thiamine Concentration 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations

α-KGDH

α-ketoglutarate dehydrogenase

BCKDH

Branched-chain keto acid dehydrogenase

CRRT

Continuous renal replacement therapy

ETKA

Erythrocyte transketolase activity

GABA

Gamma-aminobutyric acid

HPLC

High-performance liquid chromatography

PDH

Pyruvate dehydrogenase

TD

Thiamine deficiency

TDP

Thiamine diphosphate

TPP

Thiamine pyrophosphate

TTPE

Thiamine pyrophosphate effect

WE

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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