دورية أكاديمية

Relationship of blood thiamine pyrophosphate to plasma phosphate and the response to enteral nutrition plus co‐administration of intravenous thiamine during critical illness.

التفاصيل البيبلوغرافية
العنوان: Relationship of blood thiamine pyrophosphate to plasma phosphate and the response to enteral nutrition plus co‐administration of intravenous thiamine during critical illness.
المؤلفون: Collie, Jake T. B., Jiang, Alice, Abdelhamid, Yasmine Ali, Ankravs, Melissa, Bellomo, Rinaldo, Byrne, Kathleen M., Clancy, Annabelle, Finnis, Mark E., Greaves, Ronda, Tascone, Brianna, Deane, Adam M.
المصدر: Journal of Human Nutrition & Dietetics; Aug2023, Vol. 36 Issue 4, p1214-1224, 11p
مصطلحات موضوعية: INTRAVENOUS therapy, CRITICALLY ill, TIME, PATIENTS, DIETARY supplements, CATASTROPHIC illness, VITAMIN B1 deficiency, RESEARCH funding, ENTERAL feeding, VITAMIN B1, PHOSPHATES, LONGITUDINAL method, DISEASE risk factors
مستخلص: Background: Hypovitamin B1 occurs frequently during critical illness but is challenging to predict or rapidly diagnose. The aim of this study was to evaluate whether plasma phosphate concentrations predict hypovitamin B1, enteral nutrition prevents hypovitamin B1 and intravenous thiamine supplementation achieves supraphysiological concentrations in critically ill patients. Methods: Thirty‐two enterally fed critically ill patients, with a plasma phosphate concentration ≤0.65 mmol/L, formed a nested cohort within a larger randomised clinical trial. Patients were assigned to receive intravenous thiamine (200 mg) twice daily, and controls were not administered intravenous thiamine. Thiamine pyrophosphate concentrations were measured at four time points (pre‐ and post‐infusion and 4‐ and 6‐h post‐infusion) on days 1 and 3 in those allocated to thiamine and once in the control group. Results: Baseline thiamine pyrophosphate concentrations were similar (intervention 88 [67, 93] vs. control 89 [62, 110] nmol/L, p = 0.49). Eight (25%) patients had hypovitamin B1 (intervention 3 vs. control 5), with two patients in the control group remaining insufficient at day 3. There was no association between baseline phosphate and thiamine pyrophosphate concentrations. Intravenous thiamine achieved supraphysiological concentrations 6 h post first infusion, with concentrations increasing to day 3. In the control group, thiamine pyrophosphate concentrations were not statistically different between baseline and day 3 (mean change: 8.6 [−6.0, 23.1] nmol/L, p = 0.25). Conclusions: Phosphate concentrations did not predict hypovitamin B1, which was observed in 25% of the participants. Enteral nutrition alone prevented the development of new hypovitamin B1. Administration of a single 200‐mg dose of intravenous thiamine achieved supraphysiological concentrations of thiamine pyrophosphate, with repeated dosing sustaining this effect. Key points: Hypovitamin B1 appears prevalent in critically ill patients.Serum phosphate concentrations did not predict hypovitamin B1.Administration of a 200‐mg dose of intravenous thiamine achieved supraphysiological concentrations of thiamine pyrophosphate. [ABSTRACT FROM AUTHOR]
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قاعدة البيانات: Complementary Index
الوصف
تدمد:09523871
DOI:10.1111/jhn.13162