title: [Thiamine deficiency as a cause of life threatening lactic acidosis in total parenteral nutrition].
abstract: Two patients aged 37 and 44 years developed life-threatening lactic acidosis following abdominal surgery and a period of about 3 weeks of total parenteral nutrition. Septicaemia and hypoxia were excluded as possible causes. Conventional treatment including high doses of buffer agents was unsuccessful. Thiamine (vitamin B1) depletion was suspected as the cause of the metabolic acidosis, and two doses of 400 mg thiamine were given. In both patients, the lactic acidosis improved immediately, and it disappeared following the second dose of thiamine. Both patients were subsequently discharged as symptom-free. As part of the pyruvate-dehydrogenase (PDH) complex, thiamine was capable of improving the life-threatening situation.
authors.affiliation: Zentrum der Anästhesiologie und Wiederbelebung, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main.
authors.forename: G
authors.initials: G
authors.lastname: Klein
authors.forename: S
authors.initials: S
authors.lastname: Probst
authors.forename: P
authors.initials: P
authors.lastname: Kessler
authors.forename: M
authors.initials: M
authors.lastname: Behne
authors.forename: F
authors.initials: F
authors.lastname: Asskali
authors.forename: A
authors.initials: A
authors.lastname: Steuer
authors.forename: M
authors.initials: M
authors.lastname: Lorenz
mesh_terms: D000136:Acid-Base Equilibrium / Q000187:drug effects; D000140:Acidosis, Lactic / Q000209:etiology* / Q000628:therapy; D000328:Adult; D002763:Cholecystectomy; D002768:Choledochostomy; D003125:Colostomy; D003422:Critical Care; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007773:Lactates / Q000097:blood; D019344:Lactic Acid; D008134:Long-Term Care; D010289:Parenteral Nutrition, Total; D011183:Postoperative Complications / Q000209:etiology* / Q000628:therapy; D012007:Rectum / Q000601:surgery*; D013831:Thiamine / Q000008:administration & dosage; D013832:Thiamine Deficiency / Q000150:complications* / Q000628:therapy
chemical_list: D007773:Lactates; D019344:Lactic Acid; D013831:Thiamine
vernacular_title: Thiaminmangel als Ursache lebensbedrohlicher Laktatazidosen bei totaler parenteraler Ernährung.