Vitamin B1 in critically ill patients: Needs and challenges

Jake T.B. Collie, Ronda F. Greaves, Oliver A.H. Jones, Que Lam, Glenn M. Eastwood, Rinaldo Bellomo

Research output: Contribution to journalReview ArticleResearchpeer-review

82 Citations (Scopus)


Thiamine has a crucial role in energy production, and consequently thiamine deficiency (TD) has been associated with cardiac failure, neurological disorders, oxidative stress (lactic acidosis and sepsis) and refeeding syndrome (RFS). This review aims to explore analytical methodologies of thiamine compound quantification and highlight similarities, variances and limitations of current techniques and how they may be relevant to patients. An electronic search of Medline, PubMed and Embase databases for original articles published in peer-reviewed journals was conducted. MethodsNow was used to search for published analytical methods of thiamine compounds. Keywords for all databases included "thiamine and its phosphate esters", "thiamine methodology" and terms related to critical illness. Enquiries were also made to six external quality assurance (EQA) programme organisations for the inclusion of thiamine measurement. A total of 777 published articles were identified; 122 were included in this review. The most common published method is HPLC with florescence detection. Two of the six EQA organisations include a thiamine measurement programme, both measuring only whole-blood thiamine pyrophosphate (TPP). No standard measurement procedure for thiamine compound quantification was identified. Overall, there is an absence of standardisation in measurement methodologies for thiamine in clinical care. Consequently, multiple variations in method practises are prohibiting the comparison of study results as they are not traceable to any higher order reference. Traceability of certified reference materials and reference measurement procedures is needed to provide an anchor to create the link between studies and help bring consensus on the clinical importance of thiamine.

Original languageEnglish
Pages (from-to)1652-1668
Number of pages17
JournalClinical Chemistry and Laboratory Medicine
Issue number11
Publication statusPublished - Nov 2017
Externally publishedYes


  • chromatography
  • critically ill
  • mass spectrometry
  • standardisation
  • thiamine
  • vitamin B1

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