Thiamine status after major trauma

McConachie, Ian; Haskew, A

doi:10.1007/bf00256767

Cited by 22 publications

(9 citation statements)

References 22 publications

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“…Thiamin is a critical cofactor in the glycolysis and oxidation of carbohydrates for energy production. Despite thiamin supplementation in patients with severe injuries, severe thiamin deficiency developed within the first week of their injuries according to 1 study . Ten percent of critically ill patients with sepsis were found to have an absolute thiamin deficiency in 1 prospective study .…”

Section: Discussionmentioning

confidence: 99%

“…Despite thiamin supplementation in patients with severe injuries, severe thiamin deficiency developed within the first week of their injuries according to 1 study. 9 Ten percent of critically ill patients with sepsis were found to have an absolute thiamin deficiency in 1 prospective study. 10 According to another study, up to 20% of patients in the ICU were found to be thiamin deficient, and these patients had a much higher mortality rate (72%) than the overall mortality rate (50%).…”

Section: Thiaminmentioning

confidence: 99%

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Micronutrient Alterations During Continuous Renal Replacement Therapy in Critically Ill Adults: A Retrospective Study

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Section: Thiaminmentioning

confidence: 99%

Micronutrient Alterations During Continuous Renal Replacement Therapy in Critically Ill Adults: A Retrospective Study

et al. 2017

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“…Infants are particularly vulnerable to the effects of thiamine deficiency in the first months of life, and exclusively breastfed infants of thiamine‐deficient mothers are at highest risk . Thiamine deficiency is also frequently observed in patients who are critically ill or in intensive care because of increased demand for thiamine (hypermetabolism) . In clinical practice, associated comorbidities and other risk factors, such as SAM with fever and shock and use of dextrose‐based intravenous fluid, further increase the risk of thiamine deficiency .…”

Section: Thiamine Deficiency and Its Consequencesmentioning

confidence: 99%

Thiamine deficiency disorders: diagnosis, prevalence, and a roadmap for global control programs

Whitfield

Bourassa

Adamolekun

et al. 2018

Annals of the New York Academy of Sciences

230

335

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Thiamine is an essential micronutrient that plays a key role in energy metabolism. Many populations worldwide may be at risk of clinical or subclinical thiamine deficiencies, due to famine, reliance on staple crops with low thiamine content, or food preparation practices, such as milling grains and washing milled rice. Clinical manifestations of thiamine deficiency are variable; this, along with the lack of a readily accessible and widely agreed upon biomarker of thiamine status, complicates efforts to diagnose thiamine deficiency and assess its global prevalence. Strategies to identify regions at risk of thiamine deficiency through proxy measures, such as analysis of food balance sheet data and month-specific infant mortality rates, may be valuable for understanding the scope of thiamine deficiency. Urgent public health responses are warranted in high-risk regions, considering the contribution of thiamine deficiency to infant mortality and research suggesting that even subclinical thiamine deficiency in childhood may have lifelong neurodevelopmental consequences. Food fortification and maternal and/or infant thiamine supplementation have proven effective in raising thiamine status and reducing the incidence of infantile beriberi in regions where thiamine deficiency is prevalent, but trial data are limited. Efforts to determine culturally and environmentally appropriate food vehicles for thiamine fortification are ongoing.

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“…14 This suggests that low thiamine levels result from a combination of poor nutritional intake and increased catabolism in critically ill patients. Furthermore, if one uses the classic triad of mental status changes, opthalmoplegia and gait ataxia as a diagnostic indicator for WE, up to 90% of cases may be missed.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors for morbidity and mortality in elderly patients undergoing acute gastrointestinal surgery: a systematic review

Davis

Hayden

Springer

et al. 2014

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Background: Delirium is associated with increased morbidity and mortality in injured patients. Wernicke encephalopathy (WE) is delirium linked to malnutrition and chronic alcoholism. It is prevented with administration of thiamine. Our primary goal was to evaluate current blood alcohol level (BAL) testing and thiamine prophylaxis in severely injured patients. Methods: We retrospectively reviewed the cases of 1000 consecutive severely injured patients admitted to hospital between Mar. 1, 2009, and Dec. 31, 2009. We used the patients’ medical records and the Alberta Trauma Registry Results: Among 1000 patients (mean age 48 yr, male sex 70%, mean injury severity score 23, mortality 10%), 627 underwent BAL testing at admission; 221 (35%) had a BAL greater than 0 mmol/L, and 189 (30%) had a BAL above the legal limit of 17.4 mmol/L. The mean positive BAL was 41.9 mmol/L. More than 4% had a known history of alcohol abuse. More patients were assaulted (20% v. 9%) or hit by motor vehicles (10% v. 6%) when intoxicated (both p < 0.05). Most injuries occurred after falls (37%) and motor vehicle collisions (33%). Overall, 17% of patients received thiamine prophylaxis. Of the 221 patients with elevated BAL, 44% received thiamine prophylaxis. Of those with a history of alcohol abuse, 77% received thiamine prophylaxis. Conclusion: Despite the strong link between alcohol abuse, trauma and WE, more than one-third of patients were not screened for alcohol use. Furthermore, a minority of intoxicated patients received adequate prophylaxis against WE. Given the low risk and cost of BAL testing and thiamine prophylaxis and the high cost of delirium, standard protocols for prophylaxis are essential.

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Thiamine status after major trauma

Cited by 22 publications

References 22 publications

Micronutrient Alterations During Continuous Renal Replacement Therapy in Critically Ill Adults: A Retrospective Study

Micronutrient Alterations During Continuous Renal Replacement Therapy in Critically Ill Adults: A Retrospective Study

Thiamine deficiency disorders: diagnosis, prevalence, and a roadmap for global control programs

Prognostic factors for morbidity and mortality in elderly patients undergoing acute gastrointestinal surgery: a systematic review

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