The Internet Book of Critical Care Podcast IBCC Episode 100 - Wernicke encephalopathy
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Oct 16, 2020 AI Snips
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Thiamine's Critical Biochemistry Role
- Thiamine is essential for biochemical processes like citric acid cycle and preventing lactic acidosis.
- Deficiency causes neurotoxicity and is common in critical illness, not just alcoholism.
High-Dose IV Thiamine Necessity
- Give massive doses of IV thiamine for established Wernicke encephalopathy to saturate the brain quickly.
- Typical body stores are only about 30 mg, but we often give 500 mg IV thrice daily.
Wernicke's: Clinical Diagnosis Challenge
- Wernicke's encephalopathy diagnosis is primarily clinical, with the classic triad present in less than half of cases.
- Presentations vary widely, including peripheral neuropathy and organ dysfunction.