• Journal of critical care · Oct 2023

    Multicenter Study Observational Study

    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.

    • Kursat Gundogan, Gulsah G Sahin, Serap S Ergul, Nurhayat T Ozer, Sahin Temel, Turkay Akbas, Talha Ercan, Hamit Yildiz, Oguzhan S Dizdar, Zuhal Simsek, Kaniye Aydın, Ramazan Ulu, Avsar Zerman, Hayriye C Dal, Emre Aydin, Ezgi Ozyilmaz, Nazire Ateş, Kamil Gonderen, Nazif Yalcin, Arzu Topeli, Gulay Tok, Ozlem Edipoglu, Begum Ergan, Ferhan D Aydemir, Ismail H Akbudak, Recai Ergun, Recep C Yuksel, Murat Sungur, Daniel P Griffith, and Thomas R Ziegler.
    • Division of Intensive Care Medicine, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkiye; Department of Clinical Nutrition, Erciyes University Health Sciences Institute, Kayseri, Turkiye. Electronic address: kgundogan@erciyes.edu.tr.
    • J Crit Care. 2023 Oct 1; 77: 154326154326.

    Background/ObjectivesThiamine 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.Subjects/MethodsThis 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.ResultsA 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).ConclusionsOur 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.Copyright © 2023 Elsevier Inc. All rights reserved.

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