Low blood thiamine concentrations in children upon admission to the intensive care unit: risk factors and prognostic significance

Lima, Lúcio Flávio Peixoto de; Leite, Heitor Pons; Taddei, José A. de A. C.

doi:10.3945/ajcn.2009.29078

Cited by 84 publications

(71 citation statements)

References 30 publications

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“…The prevalence of TD in critically ill patients has been described [14-16] and was associated with increased morbidity and mortality [16]. Recent studies have demonstrated that additional attention is needed in the identification of thiamine deficiency (TD) and that thiamine supplementation is necessary not only in intensive care unit patients but also in patients with heart failure [15,17,18].…”

Section: Introductionmentioning

confidence: 99%

The effect of thiamine deficiency on inflammation, oxidative stress and cellular migration in an experimental model of sepsis

et al. 2014

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BackgroundSepsis is a prevalent condition in critically ill patients and may be associated with thiamine deficiency (TD). The aim of this study was to evaluate the effect of TD on inflammation, oxidative stress and cellular recruitment in a sepsis model.MethodsThe experimental sepsis model, cecal ligation and puncture (CLP), was utilized on mice in comparison with a sham procedure. The following four groups were compared against each other: SHAM with AIN93G complete chow, SHAM with thiamine deficient (TD) chow, CLP with AIN93G complete chow, and CLP with TD chow. Thiamine pyrophosphate (TPP) blood concentrations were determined, and blood and peritoneal fluid were evaluated for differences in TNF-alpha, IL-1, IL-6, KC and MCP-1/CCL2 levels. In addition, the levels of 4-HNE adducts in liver proteins were evaluated by Western Blot.ResultsThe mean TPP blood concentration from the mice fed with the complete chow was 303.3 ± 42.6 nmol/L, and TD occurred within 10 days. TNF-α and MCP-1 concentrations in the peritoneal fluid were significantly greater in the CLP with TD chow group when compared with the other groups. The blood IL-1β level, however, was lower in the CLP with TD chow group. Liver 4-HNE levels were highest in the TD chow groups. Blood mononuclear cell numbers, as well as peritoneal total leukocyte, mononuclear cell and neutrophil numbers were greater in the CLP with TD chow group. Peritoneal bacterial colony forming units (CFU) were significantly lower in the CLP with TD chow group.ConclusionTD was associated with greater bacterial clearance, oxidative stress and inflammatory response changes.

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Section: Introductionmentioning

confidence: 99%

The effect of thiamine deficiency on inflammation, oxidative stress and cellular migration in an experimental model of sepsis

et al. 2014

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“…Few observational studies in critically ill patients have identified sepsis (2–4) as an important risk factor contributing to thiamin deficiency, and that the combined sepsis and thiamin deficiency was associated with higher mortality than sepsis alone (3). The present study is the first to demonstrate that 1) sepsis inhibited intestinal carrier-mediated thiamin uptake, and that the inhibition was in proportion to the severity of sepsis (Figures 1); 2) both thiamin transporters protein and mRNA expression levels were suppressed (Figures 2 and 3, respectively); and most importantly, 3) MTPPT protein and mRNA expressions were markedly decreased and associated with proportionate reduction in ATP in animals with moderate and severe sepsis.…”

Section: Discussionmentioning

confidence: 99%

Inhibition of Intestinal Thiamin Transport in Rat Model of Sepsis

Sassoon

Zhu

Fang

et al. 2016

Critical Care Medicine

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Objective Thiamin deficiency is highly prevalent in patients with sepsis, but the mechanism by which sepsis induces thiamin deficiency is unknown. This study aimed to determine the influence of various severity of sepsis on carrier-mediated intestinal thiamin uptake, level of expressions of thiamin transporters (thiamin transporter-1 (THTR-1) and thiamin transporter-2 (THTR-2)), and mitochondrial thiamin pyrophosphate transporter (MTPPT). Design Randomized, controlled study Setting Research laboratory at a Veterans Affairs Medical Center Subjects Twenty-four Sprague-Dawley rats were randomized into controls, mild, moderate and severe sepsis with equal number of animals in each group. Measurements and Main Results Sepsis was induced by cecal ligation and puncture with the cecum ligated below the cecal valve at 25 %, 50 % and 75 % of cecal length, defined as severe, moderate and mild sepsis, respectively. Control animals underwent laparotomy only. After 2 days of induced sepsis, carrier-mediated intestinal thiamin uptake was measured using [3H]thiamin. Expressions of THTR-1, THTR-2, and MTPPT proteins and mRNA were measured. Proinflammatory cytokines (IL-1β and IL-6), and adenosine triphosphate (ATP) were also measured. Sepsis inhibited [3H]thiamin uptake and the inhibition was a function of sepsis severity. Both cell membranes thiamin transporters and MTPPT expression levels were suppressed; also levels of ATP in the intestine of animals with moderate and severe sepsis were significantly lower than that of sham operated controls. Conclusions For the first time we demonstrated that sepsis inhibited carrier-mediated intestinal thiamin uptake as a function of sepsis severity, suppressed thiamin transporters and MTPPT, leading to ATP depletion.

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“…[3] A prospective cohort study conducted in 202 children showed a low blood thiamine concentrations upon admission to ICU were detected in 57 patients (28.2%). [4] The reported incidence of deficiency in adults upon emergency admission to hospital is 21%. [5] The patient in the present report had suffered from a long-term eating disorder due to gastric cancer and operation.…”

Section: Discussionmentioning

confidence: 99%

A 48-year-old man with dyspnea, hypoxia and diplopia after gastrectomy

Liu

Jin

2015

CRIM

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Thiamine deficiency is uncommon in clinical practice. Misdiagnosis may occur because of its greatly varied and nonspecific symptoms, particularly when complicated with primary disorders. We presented a case of thiamine deficiency with multi-organ dysfunction and diplopia after gastrectomy. Supplement of thiamine resulted in the rapidly resolution of his hemodynamic conditions. It's vital important to prevent, recognize and care the condition as soon as possible in healthcare practice.

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Low blood thiamine concentrations in children upon admission to the intensive care unit: risk factors and prognostic significance

Cited by 84 publications

References 30 publications

The effect of thiamine deficiency on inflammation, oxidative stress and cellular migration in an experimental model of sepsis

The effect of thiamine deficiency on inflammation, oxidative stress and cellular migration in an experimental model of sepsis

Inhibition of Intestinal Thiamin Transport in Rat Model of Sepsis

A 48-year-old man with dyspnea, hypoxia and diplopia after gastrectomy

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