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A rare case of severe lactic acidosis in a preterm infant: lack of thiamine during total parenteral nutrition.
MedLine Citation:
PMID:  22145490     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
Total parenteral nutrition (TPN) is a revolution in neonatal intensive care unit (NICU) care, but this therapy is not without problems. A 35-week-old, 1300 g female infant was transferred to our NICU because of bilious vomiting and feeding problems. When enteral feeding was started again, a severe condition similar to the previous one developed. On the 24th day, the patient underwent surgery with a diagnosis of Hirschprung's disease. One week before surgery, the parenteral solutions were composed without vitamins because intravenous vitamin supplements suitable for infants were not available. Thereafter, the patient suffered from severe hypoglycaemia, and sepsis started to develop, accompanied by a large anion gap and metabolic acidosis which is severe lactic acidosis refractory to massive doses of bicarbonate. The acidosis improved significantly when the patient was treated with thiamin. Although TPN is life saving in the NICU, meticulous attention must be paid while treating a patient with TPN, and all possible nutrients should be provided. In this report, a case of a preterm newborn requiring a prolonged period of TPN and complicated by serious lactic acidosis is presented and discussed.
Authors:
Serife Suna Oguz; Ebru Ergenekon; Leyla Tümer; Esin Koç; Ozden Turan; Esra Onal; Canan Türkyilmaz; Yildiz Atalay
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric endocrinology & metabolism : JPEM     Volume:  24     ISSN:  0334-018X     ISO Abbreviation:  J. Pediatr. Endocrinol. Metab.     Publication Date:  2011  
Date Detail:
Created Date:  2011-12-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9508900     Medline TA:  J Pediatr Endocrinol Metab     Country:  England    
Other Details:
Languages:  eng     Pagination:  843-5     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Division of Neonatology, Gazi University Medical School, Ankara, Turkey. serifesuna@gmail.com
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