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Nutr Clin Pract. 2019 Aug;34(4):565-571. doi: 10.1002/ncp.10241. Epub 2019 Jan 15.

Thiamin Status in Adults Receiving Chronic Diuretic Therapy Prior to Admission to a Medical Intensive Care Unit: A Pilot Study.

Author information

1
Division of Medical Intensive Care, Department of Medicine, Enteral and Parenteral Nutrition Unit, Erciyes University School of Medicine, Kayseri, Turkey.
2
Nutrition and Metabolic Support Service, Emory University Hospital, Atlanta, Georgia, USA.
3
Division of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, Atlanta, Georgia, USA.

Abstract

BACKGROUND:

The aim of the study was to determine serum thiamin concentrations in critically ill medical patients who required chronic diuretic drug treatment before admission to a medical intensive care unit (ICU).

METHODS:

This prospective study was performed in a medical ICU. Subjects who received diuretic drug therapy for at least 6 months prior to ICU admission constituted the diuretic group. The control group was clinically matched adults admitted to the same ICU but without a history of diuretic therapy.

RESULTS:

A total of 50 subjects were included (25 subjects in each of the diuretic and control groups). In the diuretic group, daily dose of furosemide prior to admission was 40 mg/d (range of 20-160 mg/d). In all subjects, the ICU admission baseline blood thiamin concentrations were 31.2 ± 27.1 ng/mL. In the diuretic group, the baseline whole blood thiamin level was significantly lower compared with levels in the control group (15.5 ± 10.7 vs 46.8 ± 29.5 ng/mL; P < 0.001). On day 2 after entry, thiamin levels remained low (23.2 ± 15.4 ng/mL in the diuretic group vs 49 ± 38 ng/mL in the control group; P = 0.003). Low thiamin levels were found in 96% of patients at baseline and in 72% of patients on the second day in the diuretic group.

CONCLUSION:

Adults receiving chronic diuretic therapy and then requiring medical ICU care commonly exhibit thiamin depletion on admission to the ICU and during the initial days of ICU care.

KEYWORDS:

critical illness; diuretics; furosemide; intensive care unit; thiamin

PMID:
30644614
DOI:
10.1002/ncp.10241
[Indexed for MEDLINE]

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