Didisheim Clémence, Ballhausen Diana, Choucair Marie-Louise, Longchamp David, Natterer Julia, Ferry Thomas, Perez Marie-Hélène, Amiet Vivianne
Department of Pediatrics, Pediatric Intensive Care Unit, University Hospital and Medicine and Biology Faculty of Lausanne, Lausanne, Switzerland.
Department of Metabolic Disease, University Hospital and Medicine and Biology Faculty of Lausanne, Lausanne, Switzerland.
J Pediatr Intensive Care. 2020 Jul 15;10(4):307-310. doi: 10.1055/s-0040-1713382. eCollection 2021 Nov.
In this article, we presented a teenager, in maintenance chemotherapy for leukemia, who was admitted for digestive symptoms related to a parasitic infection and required nutritional support with parenteral nutrition. After 6 weeks, his condition worsened with refractory shock of presumed septic origin, necessitating extracorporeal membrane oxygenation. Despite hemodynamic stabilization, his lactic acidosis worsened until thiamine supplementation was started. Lactate normalized within 12 hours. Thiamine is an essential coenzyme in aerobic glycolysis, and deficiency leads to lactate accumulation through anaerobic glycolysis. Thiamine deficiency is uncommon in the pediatric population. However, it should be considered in patients at risk of nutritional deficiencies with lactic acidosis of unknown origin.
在本文中，我们介绍了一名正在接受白血病维持化疗的青少年，他因寄生虫感染相关的消化症状入院，需要肠外营养支持。6周后，他的病情恶化，出现了疑似败血症性起源的难治性休克，需要进行体外膜肺氧合。尽管血流动力学稳定，但他的乳酸酸中毒仍在恶化，直到开始补充硫胺素。补充硫胺素后12小时内乳酸水平恢复正常。硫胺素是有氧糖酵解中的一种必需辅酶，缺乏会导致通过无氧糖酵解积累乳酸。硫胺素缺乏在儿科人群中并不常见。然而，对于有营养缺乏风险且病因不明的乳酸酸中毒患者，应考虑这一情况。
