Lactic acidosis traced to thiamine deficiency related to nationwide shortage of multivitamins for total parenteral nutrition -- United States, 1997.
Since November 1996, there has been a nationwide shortage of intravenous (IV) multivitamins (MVIs) used in U.S. hospitals and home-health-care agencies for total parenteral nutrition (TPN). Patients receiving TPN without MVI supplementation are at risk for thiamine deficiency and life-threatening complications associated with severe deficiency of thiamine, a coenzyme necessary for oxidation of keto acids (Figure 1). This report describes three patients receiving TPN who had thiamine deficiency-related lactic acidosis in 1997 and presents recommendations for alternatives to parenteral MVI during the shortage.
D000140:Acidosis, Lactic / Q000209:etiology*; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D010289:Parenteral Nutrition, Total; D013832:Thiamine Deficiency / Q000150:complications* / Q000517:prevention & control; D014481:United States; D014815:Vitamins / Q000600:supply & distribution*
D014815:Vitamins