Comparison of Prehospital Glucose with or without IV Thiamine
| Autor: | David P. Lehrfeld, Frank DosSantos, Alessia Carluccio, Mark A. Merlin, Pamela Ohman-Strickland, Neil Raswant |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Emergency Medical Services
medicine.medical_specialty Endocrinology Diabetes and Metabolism emergency department Encephalopathy lcsh:Medicine Hypoglycemia Medical Toxicology Wernicke’s Encephalopathy Wernicke's encephalopathy thiamine emergency medicine medicine Thiamine Original Research Medical Nutrition business.industry lcsh:R Glasgow Coma Scale lcsh:Medical emergencies. Critical care. Intensive care. First aid food and beverages Retrospective cohort study General Medicine Emergency department lcsh:RC86-88.9 Medical Pharmacology medicine.disease Blood pressure hypoglycemia Neurology Emergency medicine Emergency Medicine Prehospital Care Glucose business human activities |
| Zdroj: | Western Journal of Emergency Medicine, Vol 13, Iss 5, Pp 406-409 (2012) Western Journal of Emergency Medicine Merlin, Mark A.; Carluccio, Alessia; Raswant, Neil; DosSantos, Frank; Ohman-Strickland, Pamela; & Lehrfeld, David P. (2012). Comparison of Prehospital Glucose with or without IV Thiamine. Western Journal of Emergency Medicine, 13(5). doi: 10.5811/westjem.2012.1.6760. Retrieved from: http://www.escholarship.org/uc/item/0f92d5g4 |
| ISSN: | 1936-9018 |
| DOI: | 10.5811/westjem.2012.1.6760. |
| Popis: | Introduction: Loading of thiamine prior to glucose administration during hypoglycemia to prevent Wernicke’s encephalopathy is routine in the prehospital setting. To date no study has looked at the validity of this therapy. Methods: We evaluated a retrospective cohort of 242 patients who received intravenous glucose for hypoglycemia comparing those who received thiamine supplementation versus those who did not. Study endpoints were heart rate, blood pressure, Glasgow Coma Scale (GCS), reentry into the 911 system, and emergency department (ED) discharge rates. Results: There were no significant differences between the thiamine, and without-thiamine groups. All patients were discharged neurologically intact or were alert and oriented when refusing transport to the hospital. None of the 242 patients re-called 911 within the immediate 24-hour period or returned to the ED. Conclusion: To our knowledge this is the first study in the literature which evaluated the use of thiamine with glucose to prevent Wernicke’s encephalopathy in the prehospital setting. We found that routine administration of thiamine with glucose did not result in differences in respiratory rate, systolic blood pressure, GCS or ED hospital discharge rates. Until further research is done to validate our results emergency medical services leadership should consider whether the routine use of thiamine in the prehospital setting is appropriate for their system. [West J Emerg Med. 2012;13(5):406-409.] |
| Databáze: | OpenAIRE |
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