Evaluation of whole blood thiamine pyrophosphate concentrations in critically ill patients receiving chronic diuretic therapy prior to admission to Turkish intensive care units: A pragmatic, multicenter, prospective study

• Published in: Journal of critical care Vol. 77; p. 154326
• Main Authors: Gundogan, Kursat, Sahin, Gulsah G., Ergul, Serap S., Ozer, Nurhayat T., Temel, Sahin, Akbas, Turkay, Ercan, Talha, Yildiz, Hamit, Dizdar, Oguzhan S., Simsek, Zuhal, Aydın, Kaniye, Ulu, Ramazan, Zerman, Avsar, Dal, Hayriye C., Aydin, Emre, Ozyilmaz, Ezgi, Ateş, Nazire, Gonderen, Kamil, Yalcin, Nazif, Topeli, Arzu, Tok, Gulay, Edipoglu, Ozlem, Ergan, Begum, Aydemir, Ferhan D., Akbudak, Ismail H., Ergun, Recai, Yuksel, Recep C., Sungur, Murat, Griffith, Daniel P., Ziegler, Thomas R.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2023; Elsevier Limited
• Subjects: Chronic obstructive pulmonary disease; Clinical outcomes; Coma; Critical illness; Diuretics; Energy; Enteral nutrition; Gastrointestinal surgery; Heart failure; Infections; Intensive care; Mortality; Nutrition; Parenteral nutrition; Phosphorus; Refeeding syndrome; Renal replacement therapy; Sepsis; Thiamine; Vitamin B; Vitamin deficiency; Diuretics; Critical illness; Refeeding syndrome; Thiamine
• ISSN: 0883-9441; 1557-8615; 1557-8615
• DOI: 10.1016/j.jcrc.2023.154326

Thiamine plays a pivotal role in energy metabolism. The aim of the study was to determine serial whole blood TPP concentrations in critically ill patients receiving chronic diuretic treatment before ICU admission and to correlate TPP levels with clinically determined serum phosphorus concentrations. This observational study was performed in 15 medical ICUs. Serial whole blood TPP concentrations were measured by HPLC at baseline and at days 2, 5 and 10 after ICU admission. A total of 221 participants were included. Of these, 18% demonstrated low TPP concentrations upon admission to the ICU, while 26% of participants demonstrated low levels at some point during the 10-day study period. Hypophosphatemia was detected in 30% of participants at some point during the 10-day period of observation. TPP levels were significantly and positively correlated with serum phosphorus levels at each time point (P < 0.05 for all). Our results show that 18% of these critically ill patients exhibited low whole blood TPP concentrations on ICU admission and 26% had low levels during the initial 10 ICU days, respectively. The modest correlation between TPP and phosphorus concentrations suggests a possible association due to a refeeding effect in ICU patients requiring chronic diuretic therapy. •In adult critically ill patients receiving diuretics prior to ICU admission, we demonstrated low thiamine levels in 18% of 221 participants on ICU admission and in 26% during the initial 10 ICU days, respectively.•The correlation pattern between TPP and phosphorus levels suggests a possible association with refeeding in adult medical ICU patients requiring chronic diuretic therapy.