Volume 3, Issue 12, 03/22/2011
Why must alcoholics with altered mental status receive intravenous vitamin B1 (thiamin) before any glucose infusions are started?
It is well known that chronic alcoholics are at high risk for being deficient in vitamin B1 (thiamin).(1,2) This is clinically relevant, as thiamin deficiency in this patient population is known to put the patient at an increased risk for Wernicke-Korsakoff Syndrome, cerebellar degeneration, and cardiovascular dysfunction.(3-5) In fact, reports have shown that approximately 13-42% of alcoholics had evidence of Wernicke-Korsakoff Syndrome and cerebellar degeneration on autopsy.(6,7) If the thiamin deficiency is left untreated, these complications can result in irreversible damage to several parts of the central nervous system (CNS).
How should
alcoholic patients with Wernicke-Korsakoff Syndrome receive thiamin
replacement?
The current standard of treatment
for such patients is to give them...
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