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Shoshin Beriberi in Critically-Ill patients: case series.

Dabar G, Harmouche C, Habr B, Riachi M, Jaber B - Nutr J (2015)

Bottom Line: Thiamine plays a fundamental role in cellular metabolism.The classical syndrome caused by thiamine deficiency is beriberi, and its fulminant variant, once considered an uncommon finding, is now encountered among the critically ill.We present a case series of four critically ill non-septic non-alcoholic patients with severe lactic acidosis and refractory cardio-circulatory collapse caused by acute fulminant beriberi, which drastically responded to thiamine administration.In critical care settings, increased awareness of this life-threatening but reversible condition is a requirement, especially among patients receiving parenteral nutrition and those with unexplained recalcitrant lactic acidosis.

View Article: PubMed Central - PubMed

Affiliation: Pulmonary and critical section, Hotel Dieu de France Hospital, Saint Joseph University School of Medicine, 16-16830, Beirut, Lebanon. georgedabar@yahoo.com.

ABSTRACT
Thiamine plays a fundamental role in cellular metabolism. The classical syndrome caused by thiamine deficiency is beriberi, and its fulminant variant, once considered an uncommon finding, is now encountered among the critically ill.We present a case series of four critically ill non-septic non-alcoholic patients with severe lactic acidosis and refractory cardio-circulatory collapse caused by acute fulminant beriberi, which drastically responded to thiamine administration.In critical care settings, increased awareness of this life-threatening but reversible condition is a requirement, especially among patients receiving parenteral nutrition and those with unexplained recalcitrant lactic acidosis.

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Related in: MedlinePlus

The four charts represent the trend of MAP along with the vasopressor doses prior and following Thiamine infusion. In the four charts the x- Axis is hours and the Arrow points at the time of the initial Thiamine infusion.1.a. Case # 1. 1.b. Case # 2, 1.c.: Case # 3, 1.d.: Case # 4. In the charts Epinephrine (Adrenaline) and Norepinephrine are shown in milliliters per hour, conversion to mg per hour is 0.25 mg/ml and 0.2 mg/ml respectively
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Fig1: The four charts represent the trend of MAP along with the vasopressor doses prior and following Thiamine infusion. In the four charts the x- Axis is hours and the Arrow points at the time of the initial Thiamine infusion.1.a. Case # 1. 1.b. Case # 2, 1.c.: Case # 3, 1.d.: Case # 4. In the charts Epinephrine (Adrenaline) and Norepinephrine are shown in milliliters per hour, conversion to mg per hour is 0.25 mg/ml and 0.2 mg/ml respectively

Mentions: In this article, we present 4 cases (Table 1) of hospitalized patients without history of alcohol dependence, encountered between 2008 and 2009, who suffered from recalcitrant metabolic acidosis and refractory hypotension (Fig. 1) caused by acute fulminant cardiac beriberi, and a review of the literature is done.Table 1


Shoshin Beriberi in Critically-Ill patients: case series.

Dabar G, Harmouche C, Habr B, Riachi M, Jaber B - Nutr J (2015)

The four charts represent the trend of MAP along with the vasopressor doses prior and following Thiamine infusion. In the four charts the x- Axis is hours and the Arrow points at the time of the initial Thiamine infusion.1.a. Case # 1. 1.b. Case # 2, 1.c.: Case # 3, 1.d.: Case # 4. In the charts Epinephrine (Adrenaline) and Norepinephrine are shown in milliliters per hour, conversion to mg per hour is 0.25 mg/ml and 0.2 mg/ml respectively
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4443551&req=5

Fig1: The four charts represent the trend of MAP along with the vasopressor doses prior and following Thiamine infusion. In the four charts the x- Axis is hours and the Arrow points at the time of the initial Thiamine infusion.1.a. Case # 1. 1.b. Case # 2, 1.c.: Case # 3, 1.d.: Case # 4. In the charts Epinephrine (Adrenaline) and Norepinephrine are shown in milliliters per hour, conversion to mg per hour is 0.25 mg/ml and 0.2 mg/ml respectively
Mentions: In this article, we present 4 cases (Table 1) of hospitalized patients without history of alcohol dependence, encountered between 2008 and 2009, who suffered from recalcitrant metabolic acidosis and refractory hypotension (Fig. 1) caused by acute fulminant cardiac beriberi, and a review of the literature is done.Table 1

Bottom Line: Thiamine plays a fundamental role in cellular metabolism.The classical syndrome caused by thiamine deficiency is beriberi, and its fulminant variant, once considered an uncommon finding, is now encountered among the critically ill.We present a case series of four critically ill non-septic non-alcoholic patients with severe lactic acidosis and refractory cardio-circulatory collapse caused by acute fulminant beriberi, which drastically responded to thiamine administration.In critical care settings, increased awareness of this life-threatening but reversible condition is a requirement, especially among patients receiving parenteral nutrition and those with unexplained recalcitrant lactic acidosis.

View Article: PubMed Central - PubMed

Affiliation: Pulmonary and critical section, Hotel Dieu de France Hospital, Saint Joseph University School of Medicine, 16-16830, Beirut, Lebanon. georgedabar@yahoo.com.

ABSTRACT
Thiamine plays a fundamental role in cellular metabolism. The classical syndrome caused by thiamine deficiency is beriberi, and its fulminant variant, once considered an uncommon finding, is now encountered among the critically ill.We present a case series of four critically ill non-septic non-alcoholic patients with severe lactic acidosis and refractory cardio-circulatory collapse caused by acute fulminant beriberi, which drastically responded to thiamine administration.In critical care settings, increased awareness of this life-threatening but reversible condition is a requirement, especially among patients receiving parenteral nutrition and those with unexplained recalcitrant lactic acidosis.

Show MeSH
Related in: MedlinePlus