Thread by @GasBugZa

Last in the session if Prof Veronia Ueckerman, with a talk entitled - Thiamine, what is all the W(h)ining About?
#CCSSA2022 #critcare #FOAMcc

Thiamine is a water-soluble vitamin essential for carbohydrate metabolism. It is a cofactor for four enzymes used in ATP production. It has limited storage in the human body, and is absorbed in the small intestine.
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Risk factors for thiamine deficiency include
- Malnutrition
- Chronic alcohol consumption
- Pregnancy (due to increased requirements)
- Excess renal losses (chronic diuretic therapy)
- Obesity pre-bariatric surgery and post surgery
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Thiamine deficiency can contribute to the development of ICU complications, including heart failure, ICU-acquired weakness, unexplained lactic acidosis.
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Refeeding syndrome is common in medical ICUs, particularly in South Africa, and thiamine supplementation is crucial in this population.
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Metabolic resuscitation - the timing of this is critical, as delays have been shown to result in increased mortality.
doi.org/10.1017/S00071…
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There are dire consequences if deficiency is protracted, so early metabolic resuscitation is essential.
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