Correlation between vitamin B<sub>1</sub> levels with sepsis and lactate levels in critically ill patients_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

YUAN Binbin ¹ , XU Ying ² , PAN Huanyan ³ ,  GU Qin ^1,2

1. Intensive Care Unit, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jangsu 210008, P. R. China;
2. Intensive Care Unit, Drum Tower Hospital Affiliated to Nanjing University School of Medicine, Nanjing, Jangsu 210008, P. R. China;
3. Department of Pharmacy, Drum Tower Hospital Affiliated to China Pharmaceutical University, Nanjing, Jangsu 210008, P. R. China;

Corresponding author：

GU Qin, Email: icuguqin@sina.com

Keywords：

Vitamin B₁; critically ill patients; sepsis; lactic acid

DOI：

10.7507/1671-6205.202306017

Video：

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Objective To determine the incidence of vitamin B₁ deficiency in critically ill patients, to compare vitamin B₁ levels between septic and non-septic patients, and to explore the relationship between vitamin B₁ levels and lactate levels. Methods Using a retrospective study method, critically ill patients admitted to the Department of Intensive Care of Nanjing Drum Tower Hospital from February 2022 to November 2022 were included in the study, and the patients were divided into sepsis and non-sepsis groups according to the admission diagnosis, and the differences in the vitamin B₁ levels of the patients between the two groups were analyzed, as well as the correlation between the vitamin B₁ levels and the lactic acid levels. Results There was a significant difference in serum vitamin B₁ levels between the sepsis patients and the non-sepsis patients [(1.6±0.3)ng/mL vs. (2.1±0.2)ng/mL, P=0. 009]. For all patients, there was no correlation between vitamin B₁ levels and lactate levels. But when the patient was in a hyperlactate state (lactate level ≥2 mmol/L), vitamin B₁ levels were significantly negatively correlated with lactate levels (r=–0. 229, P=0. 004). Conclusions Vitamin B₁ deficiency is prevalent in critically ill patients and is strongly correlated with whether or not the patient is septic. Vitamin B₁ levels are significantly and negatively correlated with lactate levels when the patient's lactate level is ≥2 mmol/L.

Citation： YUAN Binbin, XU Ying, PAN Huanyan, GU Qin. Correlation between vitamin B₁ levels with sepsis and lactate levels in critically ill patients. Chinese Journal of Respiratory and Critical Care Medicine, 2023, 22(9): 624-628. doi: 10.7507/1671-6205.202306017 Copy

1.	Manzanares W, Hardy G. Thiamine supplementation in the critically ill. Curr Opin Clin Nutr Metab Care, 2011, 14(6): 610-617.
2.	Sriram K, Manzanares W, Joseph K. Thiamine in nutrition therapy. Nutr Clin Pract, 2012, 27(1): 41-50.
3.	Mallat J, Lemyze M, Thevenin D. Do not forget to give thiamine to your septic shock patient! J Thorac Dis, 2016, 8(6): 1062-1066.
4.	Jamieson CP, Obeid OA, Powell-Tuck J. The thiamin, riboflavin and pyridoxine status of patients on emergency admission to hospital. Clin Nutr, 1999, 18(2): 87-91.
5.	Cruickshank AM, Telfer AB, Shenkin A. Thiamine deficiency in the critically ill. Intensive Care Med, 1988, 14(4): 384-387.
6.	Lima LF, Leite HP, Taddei JA. Low blood thiamine concentrations in children upon admission to the intensive care unit: risk factors and prognostic significance. Am J Clin Nutr, 2011, 93(1): 57-61.
7.	Costa NA, Gut AL, de Souza Dorna M, et al. Serum thiamine concentration and oxidative stress as predictors of mortality in patients with septic shock. J Crit Care, 2014, 29(2): 249-252.
8.	Donnino MW, Carney E, Cocchi MN, et al. Thiamine deficiency in critically ill patients with sepsis. J Crit Care, 2010, 25(4): 576-581.
9.	Donnino MW, Andersen LW, Chase M, et al. Randomized, double-blind, placebo-controlled trial of thiamine as a metabolic resuscitator in septic shock: a pilot study. Crit Care Med, 2016, 44(2): 360-367.
10.	中国医师协会急诊医师分会, 中国研究型医院学会休克与脓毒症专业委员会. 中国脓毒症/脓毒性休克急诊治疗指南(2018). 感染、炎症、修复, 2019, 20(1): 3-22.
11.	Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA, 2016, 315(8): 801-810.
12.	Shankar-Hari M, Phillips GS, Levy ML, et al. Developing a New Definition and Assessing New Clinical Criteria for Septic Shock: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA, 2016, 315(8): 775-787.
13.	Quest Diagnostics. Micronutrient, Vitamin B1 (Thiamine), Blood[EB/OL]. (2019)[2023-09-14]. https://testdirectory.questdiagnostics.com/.
14.	Corcoran TB, O'neill MA, Webb SA, et al. Prevalence of vitamin deficiencies on admission: relationship to hospital mortality in critically ill patients. Anaesth Intensive Care, 2009, 37(2): 254-260.
15.	Garcia-Alvarez M, Marik P, Bellomo R. Sepsis-associated hyperlactatemia. Crit Care, 2014, 18(5): 503.
16.	Iglesias J, Vassallo AV, Patel VV, et al. Outcomes of metabolic resuscitation using ascorbic acid, thiamine, and glucocorticoids in the early treatment of sepsis: The ORANGES Trial. Chest, 2020, 158(1): 164-173.
17.	Coloretti I, Biagioni E, Venturelli S, et al. Adjunctive therapy with vitamin c and thiamine in patients treated with steroids for refractory septic shock: a propensity matched before-after, case-control study. J Crit Care, 2020, 59: 37-41.
18.	Marik PE, Khangoora V, Rivera R, et al. Hydrocortisone, citamin C, and thiamine for the treatment of severe sepsis and septic shock: a retrospective before-after study. Chest, 2017, 151(6): 1229-1238.
19.	刘琼, 王金荣, 崔朝勃. 氢化可的松、维生素C和维生素B1联合治疗脓毒症研究进展. 中国呼吸与危重监护杂志, 2021, 20(5): 366-371.
20.	桑珍珍, 王淑娟, 王伟, 等. 氢化可的松联合维生素C和维生素B1治疗老年感染性休克的临床疗效. 中国老年学杂志, 2020, 40(20): 4351-4354.
21.	Suetrong B, Walley KR. Lactic acidosis in sepsis: it's not all anaerobic. Implications for diagnosis and management. Chest, 2016, 149(1): 252-261.
22.	Donnino MW, Vega J, Miller J, et al. Myths and misconceptions of Wernicke's encephalopathy: what every emergency physician should know. Ann Emerg Med, 2007, 50(6): 715-721.
23.	Singer P, Berger MM, Van Den Berghe G, et al. ESPEN Guidelines on Parenteral Nutrition: intensive care. Clin Nutr, 2009, 28(4): 387-400.
24.	Nixon PF, Diefenbach RJ, Duggleby RG. Inhibition of transketolase and pyruvate decarboxylase by omeprazole. Biochem Pharmacol, 1992, 44(1): 177-179.

1. Manzanares W, Hardy G. Thiamine supplementation in the critically ill. Curr Opin Clin Nutr Metab Care, 2011, 14(6): 610-617.
2. Sriram K, Manzanares W, Joseph K. Thiamine in nutrition therapy. Nutr Clin Pract, 2012, 27(1): 41-50.
3. Mallat J, Lemyze M, Thevenin D. Do not forget to give thiamine to your septic shock patient! J Thorac Dis, 2016, 8(6): 1062-1066.
4. Jamieson CP, Obeid OA, Powell-Tuck J. The thiamin, riboflavin and pyridoxine status of patients on emergency admission to hospital. Clin Nutr, 1999, 18(2): 87-91.
5. Cruickshank AM, Telfer AB, Shenkin A. Thiamine deficiency in the critically ill. Intensive Care Med, 1988, 14(4): 384-387.
6. Lima LF, Leite HP, Taddei JA. Low blood thiamine concentrations in children upon admission to the intensive care unit: risk factors and prognostic significance. Am J Clin Nutr, 2011, 93(1): 57-61.
7. Costa NA, Gut AL, de Souza Dorna M, et al. Serum thiamine concentration and oxidative stress as predictors of mortality in patients with septic shock. J Crit Care, 2014, 29(2): 249-252.
8. Donnino MW, Carney E, Cocchi MN, et al. Thiamine deficiency in critically ill patients with sepsis. J Crit Care, 2010, 25(4): 576-581.
9. Donnino MW, Andersen LW, Chase M, et al. Randomized, double-blind, placebo-controlled trial of thiamine as a metabolic resuscitator in septic shock: a pilot study. Crit Care Med, 2016, 44(2): 360-367.
10. 中国医师协会急诊医师分会, 中国研究型医院学会休克与脓毒症专业委员会. 中国脓毒症/脓毒性休克急诊治疗指南(2018). 感染、炎症、修复, 2019, 20(1): 3-22.
11. Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA, 2016, 315(8): 801-810.
12. Shankar-Hari M, Phillips GS, Levy ML, et al. Developing a New Definition and Assessing New Clinical Criteria for Septic Shock: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA, 2016, 315(8): 775-787.
13. Quest Diagnostics. Micronutrient, Vitamin B1 (Thiamine), Blood[EB/OL]. (2019)[2023-09-14]. https://testdirectory.questdiagnostics.com/.
14. Corcoran TB, O'neill MA, Webb SA, et al. Prevalence of vitamin deficiencies on admission: relationship to hospital mortality in critically ill patients. Anaesth Intensive Care, 2009, 37(2): 254-260.
15. Garcia-Alvarez M, Marik P, Bellomo R. Sepsis-associated hyperlactatemia. Crit Care, 2014, 18(5): 503.
16. Iglesias J, Vassallo AV, Patel VV, et al. Outcomes of metabolic resuscitation using ascorbic acid, thiamine, and glucocorticoids in the early treatment of sepsis: The ORANGES Trial. Chest, 2020, 158(1): 164-173.
17. Coloretti I, Biagioni E, Venturelli S, et al. Adjunctive therapy with vitamin c and thiamine in patients treated with steroids for refractory septic shock: a propensity matched before-after, case-control study. J Crit Care, 2020, 59: 37-41.
18. Marik PE, Khangoora V, Rivera R, et al. Hydrocortisone, citamin C, and thiamine for the treatment of severe sepsis and septic shock: a retrospective before-after study. Chest, 2017, 151(6): 1229-1238.
19. 刘琼, 王金荣, 崔朝勃. 氢化可的松、维生素C和维生素B1联合治疗脓毒症研究进展. 中国呼吸与危重监护杂志, 2021, 20(5): 366-371.
20. 桑珍珍, 王淑娟, 王伟, 等. 氢化可的松联合维生素C和维生素B1治疗老年感染性休克的临床疗效. 中国老年学杂志, 2020, 40(20): 4351-4354.
21. Suetrong B, Walley KR. Lactic acidosis in sepsis: it's not all anaerobic. Implications for diagnosis and management. Chest, 2016, 149(1): 252-261.
22. Donnino MW, Vega J, Miller J, et al. Myths and misconceptions of Wernicke's encephalopathy: what every emergency physician should know. Ann Emerg Med, 2007, 50(6): 715-721.
23. Singer P, Berger MM, Van Den Berghe G, et al. ESPEN Guidelines on Parenteral Nutrition: intensive care. Clin Nutr, 2009, 28(4): 387-400.
24. Nixon PF, Diefenbach RJ, Duggleby RG. Inhibition of transketolase and pyruvate decarboxylase by omeprazole. Biochem Pharmacol, 1992, 44(1): 177-179.

Chinese Journal of Respiratory and Critical Care Medicine

Correlation between vitamin B₁ levels with sepsis and lactate levels in critically ill patients

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Correlation between vitamin B1 levels with sepsis and lactate levels in critically ill patients

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Correlation between vitamin B₁ levels with sepsis and lactate levels in critically ill patients