외과계 중환자실 환자에서 티아민 결핍에 의해 발생한 습성 각기병과 베르니케 뇌병증
Experiences of Wet Beriberi and Wernicke’s Encephalopathy Caused by Thiamine Deficiency in Critically Ill Patients
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Wet beriberi and Wernicke’s encephalopathy (WE) are caused by thiamine deficiency and are potentially lethal and serious diseases. Thiamine deficiency occurs mainly due to poor oral intake or inadequate provision of thiamine in enteral or parenteral nutrition therapy. We report cases of wet beriberi and WE that developed after surgery in a surgical intensive care unit. The first patient, who was diagnosed with wet beriberi, underwent right total mastectomy and radical subtotal gastrectomy, simultaneously. The second was diagnosed with irreversible WE, respectively, due to long-term malnutrition. In both cases, intravenous replacement of thiamine was initiated after the admission to the surgical intensive care unit. However, comatose mentality of the second patient did not improve. As a result, we conclude that, if a patient’s clinical feature is suspected to be thiamine deficiency, prompt intravenous thiamine replacement is needed.
Abstract
Wet beriberi and Wernicke’s encephalopathy (WE) are caused by thiamine deficiency and are potentially lethal and serious diseases. Thiamine deficiency occurs mainly due to poor oral intake or inadequate provision of thiamine in enteral or parenteral nutrition therapy. We report cases of wet beriberi and WE that developed after surgery in a surgical intensive care unit. The first patient, who was diagnosed with wet beriberi, underwent right total mastectomy and radical subtotal gastrectomy, simultaneously. The second was diagnosed with irreversible WE, respectively, due to long-term malnutrition. In both cases, intravenous replacement of thiamine was initiated after the admission to the surgical intensive care unit. However, comatose mentality of the second patient did not improve. As a result, we conclude that, if a patient’s clinical feature is suspected to be thiamine deficiency, prompt intravenous thiamine replacement is needed.
참고문헌 (13)
- Kumar N, "Neurologic presentations of nutritional deficiencies", Neurol Clin, 28, pp.107~170 (2010)
- Salas-Salvadó J, "Wernicke's syndrome after bariatric surgery", Clin Nutr, 19, pp.371~373 (2000)
- Sechi G, "Wernicke's encephalopathy: new clinical settings and recent advances in diagnosis and management", Lancet Neurol, 6, pp.442~455 (2007)
- Soukoulis V, "Micronutrient deficiencies an unmet need in heart failure", J Am Coll Cardiol, 54, pp.1660~1673 (2009)
- Zenuk C, "Thiamine deficiency in congestive heart failure patients receiving long term furosemide therapy", Can J Clin Pharmacol, 10, pp.184~188 (2003)
- Dunn SP, "Nutrition and heart failure: impact of drug therapies and management strategies", Nutr Clin Pract, 24, pp.60~75 (2009)
- Sriram K, "Thiamine in nutrition therapy", Nutr Clin Pract, 27, pp.41~50 (2012)
- Galvin R, "EFNS: EFNS guidelines for diagnosis, therapy and prevention of Wernicke encephalopathy", Eur J Neurol, 17, pp.1408~1418 (2010)
- Wrenn KD, "A toxicity study of parenteral thiamine hydrochloride", Ann Emerg Med, 18, pp.867~870 (1989)
- Wrenn KD, "Is intravenous thiamine safe?", Am J Emerg Med, 10, pp.165~ (1992)
- Stanga Z, "Nutrition in clinical practice-the refeeding syndrome: illustrative cases and guidelines for prevention and treatment", Eur J Clin Nutr, 62, pp.687~694 (2008)
- Fried RT, "Wernicke's encephalopathy in the intensive care patient", Crit Care Med, 18, pp.779~780 (1990)
- 이한나, "수술 후 경정맥 영양공급과 일시적인 경구영양법을 받은 환자에서 발생한 베르니케 뇌병증 1예-증례 보고-", 대한중환자의학회지, 25(3), pp.186~189 (2010), 대한중환자의학회