Wernicke's encephalopathy. Complication of intravenous hyperalimentation

Krämer, Johannes

doi:10.1001/jama.238.20.2176

Cited by 24 publications

(6 citation statements)

References 2 publications

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“…The 40-min effect time, likewise, is not generalizable to human patients. Table 3 summarizes the level of evidence in the 19 articles included in this review (4,9,10,(12)(13)(14)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29).…”

Section: Resultsmentioning

confidence: 99%

“…Only one case appears to show acute degradation in mental status after glucose administration, but the timeline and dosage of glucose is not clear in the case report, which reads, almost in its entirety: (21) Case report E Adequate Gibb WR, Gorsuch AN, Lees AJ, Yudkin JS, 1985 (12) Case report E Adequate Hack JB, Hoffman RS, 1998 (20) Expert opinion F Adequate Jordan LR, Zelaya FO, Rose SE, et al, 1998 (17) Animal model E Outstanding Koguchi K, Nakatsuji Y, Abe K, Sakoda S, 2004 (13) Case report E Unsatisfactory Kramer J, Goodwin JA, 1977 (23) Case report E Adequate Lindberg MC, Oyler RA, 1990 (24) Case report/common practice E/F Poor Mayes GA, 1989 (14) Expert ''A 61-year-old man was admitted with slight confusion. He had been a heavy drinker for several years and had general fatigue.…”

Section: Discussionmentioning

confidence: 99%

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Glucose before Thiamine for Wernicke Encephalopathy: A Literature Review

Schabelman

Kuo

2012

The Journal of Emergency Medicine

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Glucose before Thiamine for Wernicke Encephalopathy: A Literature Review

Schabelman

Kuo

2012

The Journal of Emergency Medicine

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“…Thiamin deficiency resulting from PN without multivitamins has been reported since the 1970s. [31][32][33][34] Yet this practice continues to occur owing to both product shortages and clinician knowledge deficits. Three cases of severe, acute lactic acidosis from thiamin deficiency in patients who were admitted to a Veterans Affairs (VA) hospital between 1981 and 1982 and received PN without IV multivitamins in the postoperative setting were described in a 1985 report.…”

Section: Multivitaminsmentioning

confidence: 99%

Managing nutrition support product shortages: What have we learned?

2022

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Product shortages related to the components of parenteral nutrition (PN) therapy have been well described over the past decade. The situation has more recently worsened and expanded globally because of the impact the COVID-19 pandemic has placed on supply chain issues and workforce demand. The impact of enteral nutrition (EN) product shortages is less well documented when compared with PN, and development of management strategies is often left up to the discretion of individual providers. The recent crisis in infant formula supply has heightened the national awareness of how a nutrition support product shortage can significantly impact patient safety. This review provides a historical perspective of PN and EN product shortages to gain insight into the lessons learned and applies this to strategies for managing current and future product shortages. Strategies for managing PN and EN shortages can best succeed if they are tailored to address aspects that are unique to the inpatient and outpatient care setting. In addition, patients who transition between care settings are vulnerable to harm related to product shortages if measures are not in place to communicate and address these shortages. Teamwork and communication within an organization and among key stakeholders are necessary to develop processes that aim to minimize patient harm related to product shortages.

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“…It showed a CC area of 435.6 mm 2 , and the fourth taken 3 weeks after the third showed an area of 434. 8 With the exception of the patient above, 5 patients (3 alcoholics and 2 nonalcoholics) received follow-up MRI a few weeks (mean 5.3 weeks) after the initial one. However, no significant difference was found between the initial and the follow-up areas of the total CC (P = .136; 568.2 ± 131.7 mm 2 for the initial, 585.4 ± 146.9 mm 2 for the follow-up, P = .815 for values normalized to head size) or of each of the 5 subregions (P = .562 for C5).…”

Section: Follow-up Survey Of CC Atrophymentioning

confidence: 99%

“…Wernicke's encephalopathy (WE) is a neurologic emergency caused by thiamine (vitamin B1) deficiency and presents with ophthalmoplegia, confusion, and ataxia. 1 The most common cause of thiamine deficiency is chronic alcoholism, but other causes such as hyperemesis gravidarum, [2][3][4] fasting, 5 hemodialysis, 6 uremia, 7 and hyperalimentation 8 have been reported. Pathologic findings show varying degrees of necrosis, vascular proliferation, and astrocyte and microglial proliferation, with petechial hemorrhages in the medial thalami, mammillary bodies, periaqueductal gray, floor of fourth ventricle, and superior cerebellar vermis.…”

mentioning

confidence: 99%