{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T15:32:35Z","timestamp":1780068755776,"version":"3.54.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2020,12,31]],"date-time":"2020-12-31T00:00:00Z","timestamp":1609372800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"intramural grant from Postgraduate Institute of Medical Education and Research, Chandigarh for procurement of laboratory chemicals"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,29]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Mitochondrial dysfunction is central to sepsis-induced multi-organ dysfunction. Thiamine deficiency may contribute to mitochondrial dysfunction and thus high mortality. Study was planned to assess thiamine status in children with septic shock in comparison to healthy controls from a developing country and to study the effect of thiamine levels on its outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective case-control study (April 2017 to May 2018) enrolling consecutive children with septic shock as \u2018cases\u2019 (n\u2009=\u200976), their healthy siblings (n\u2009=\u200951) and apparently healthy children from immunization clinic (n\u2009=\u200935) as \u2018controls\u2019. Whole blood total thiamine (WBTT) level was measured on days 1, 10 and 1-month post-discharge. Outcome parameters were acute care area free days on days 14 and 28, and mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>WBTT [nMol\/l; median (interquartile range, IQR)] was significantly lower on day 1 in cases compared with sibling controls [23.1 (21.8\u201326.3) vs. 36.9 (33.6\u201340.5); p\u2009&amp;lt;\u20090.001]. It fell further on day 10 [20.8 (18.1\u201321.1); p\u2009&amp;lt;\u20090.02]. Levels rose significantly 1-month post-discharge [35.5 (31.2\u201336.6)] and became comparable to sibling controls (p\u2009=\u20090.4). Immunization clinic controls also had lower WBTT [42.3 (40.1\u201345.9)], but was significantly higher than sibling controls and cases at 1-month post-discharge (p\u2009&amp;lt;\u20090.001). Survivors and non-survivors of septic shock were similar. WBTT levels did not correlate with any of the severity indicators of septic shock or its outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>WBTT was significantly low in all children, and fell further during septic shock. Observed severe deficiency might have precluded any further association of thiamine levels with severity of septic shock and its outcome. Data obtained may inform trials on metabolic resuscitation in paediatric septic shock in developing countries.<\/jats:p><jats:p>Lay summary<\/jats:p><jats:p>Thiamine deficiency may contribute to high mortality in paediatric septic shock as thiamine is an essential factor for functioning of mitochondria, the powerhouse of the cells. This prospective case\u2013control study was conducted to assess thiamine status in children with septic shock in comparison with healthy controls in a developing country. Consecutive children with fluid-refractory septic shock were enrolled as \u2018cases\u2019. Their apparently healthy siblings, and apparently healthy children from immunization clinic, were enrolled as \u2018controls\u2019. The whole blood total thiamine (WBTT) level was measured on days 1, 10 and 1\u2009month after hospital discharge. Seventy-six children were enrolled as cases, 51 children as sibling controls and 35 children as immunization clinic controls. WBTT was significantly lower on day 1 in cases as compared with their sibling controls. It fell further on day 10. The level rose significantly after a month of discharge and became comparable to sibling controls. Immunization clinic controls also had lower WBTT but was significantly higher compared with sibling controls and cases at 1-month post-discharge. Survivors and non-survivors of septic shock had similar WBTT levels. Observed severe deficiency might have precluded any further association of thiamine levels with septic shock outcome.<\/jats:p><\/jats:sec>","DOI":"10.1093\/tropej\/fmaa107","type":"journal-article","created":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T12:39:02Z","timestamp":1603802342000},"source":"Crossref","is-referenced-by-count":7,"title":["Thiamine Status in Children with Septic Shock from a Developing Country: A Prospective Case\u2013Control Study"],"prefix":"10.1093","volume":"67","author":[{"given":"Kumar Manish","family":"Raj","sequence":"first","affiliation":[{"name":"Division of Pediatric Critical Care, Advanced Pediatric Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4334-2652","authenticated-orcid":false,"given":"Arun K","family":"Baranwal","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care, Advanced Pediatric Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Savita Verma","family":"Attri","sequence":"additional","affiliation":[{"name":"Pediatric Biochemistry Unit, Advanced Pediatric Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muralidharan","family":"Jayashree","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care, Advanced Pediatric Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Praveen","family":"Kumar-M","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay","family":"Patial","sequence":"additional","affiliation":[{"name":"Pediatric Biochemistry Unit, Advanced Pediatric Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arushi Gahlot","family":"Saini","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurology, Advanced Pediatric Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,12,31]]},"reference":[{"key":"2021031111255226900_fmaa107-B1","doi-asserted-by":"crossref","first-page":"e367","DOI":"10.1097\/PCC.0000000000001584","article-title":"Suspecting hyperferritinemic sepsis in iron-deficient population: do we need a lower plasma ferritin threshold?","volume":"19","author":"Ghosh","year":"2018","journal-title":"Pediatr Crit Care Med"},{"key":"2021031111255226900_fmaa107-B2","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1016\/j.jcrc.2016.07.022","article-title":"Reduction in procalcitonin level and outcome in critically ill children with severe sepsis\/septic shock-A pilot study","volume":"36","author":"Poddar","year":"2016","journal-title":"J Crit Care"},{"key":"2021031111255226900_fmaa107-B3","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1007\/s00134-014-3358-9","article-title":"Dexamethasone pretreatment for 24 h versus 6 h for prevention of postextubation airway obstruction in children: a randomized double-blind trial","volume":"40","author":"Baranwal","year":"2014","journal-title":"Intensive Care Med"},{"key":"2021031111255226900_fmaa107-B4","first-page":"73","article-title":"Disorders of nutritional status in sepsis - facts and myths","volume":"2","author":"Kosa\u0142ka","year":"2017","journal-title":"Prz Gastroenterol"},{"key":"2021031111255226900_fmaa107-B5","doi-asserted-by":"crossref","first-page":"e52","DOI":"10.1097\/PCC.0000000000002198","article-title":"Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children","volume":"21","author":"Weiss","year":"2020","journal-title":"Pediatr Crit Care Med"},{"key":"2021031111255226900_fmaa107-B6","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1007\/3-540-26900-2_5","volume-title":"Functional Hemodynamic Monitoring. 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