title: Severe lactic acidosis and multiorgan failure due to thiamine deficiency during total parenteral nutrition.
abstract: A 16-year-old perioperative paediatric patient presented with refractory lactic acidosis and multiorgan failure due to thiamine-deficient total parenteral nutrition during a recent national multivitamin shortage. Urgent empiric administration of intravenous thiamine resulted in prompt recovery from this life-threatening condition. Despite readily available treatment, a high index of suspicion is required to prevent cardiovascular collapse and mortality.
authors.affiliation: Department of Pediatric Critical Care, Stanford University, Palo Alto, California, USA.
authors.forename: Musaab
authors.initials: M
authors.lastname: Ramsi
authors.affiliation: Department of Pediatric Pharmacy, Stanford University, Palo Alto, California, USA.
authors.forename: Claire
authors.initials: C
authors.lastname: Mowbray
authors.affiliation: Department of Pediatric Surgery, Stanford University, Palo Alto, California, USA.
authors.forename: Gary
authors.initials: G
authors.lastname: Hartman
authors.affiliation: Department of Pediatric Critical Care, Stanford University, Palo Alto, California, USA.
authors.forename: Natalie
authors.initials: N
authors.lastname: Pageler
mesh_terms: D000140:Acidosis, Lactic / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D000293:Adolescent; D003937:Diagnosis, Differential; D006801:Humans; D006863:Hydrogen-Ion Concentration; D019344:Lactic Acid / Q000097:blood; D008297:Male; D009102:Multiple Organ Failure / Q000175:diagnosis / Q000209:etiology*; D010289:Parenteral Nutrition, Total; D013832:Thiamine Deficiency / Q000150:complications* / Q000628:therapy
chemical_list: D019344:Lactic Acid