RESUMO
Thiamine (vitamin B1) is an essential vitamin found in most food products in developed nations. Deficiencies in this crucial vitamin lead to diseases related to nutritional needs, metabolic demands, enzymatic function, and neurological inflammation. We present an 18-year-old patient with a history of nasopharyngeal carcinoma and total parenteral nutrition (TPN) dependence who experienced neurological manifestations and heart failure, likely due to underlying thiamine deficiency, dehydration, and vasodilation. The patient exhibited heart failure due to thiamine deficiency that was overlooked by her care team secondary to a reaction to preservatives associated with vitamins in TPN, lapse in communication, and decreased compliance.
RESUMO
Propofol sedation is used more frequently in pediatric procedures because of its ability to provide varying sedation levels. The authors evaluated all outpatient pediatric procedures using propofol sedation over a 6-year period. All sedation was provided by pediatric intensivists at a single institution. In all, 4716 procedures were recorded during the study period; 15% of procedures were associated with minor complications, whereas only 0.1% of procedures were associated with major complications. Significantly more major complications associated with propofol occurred during bronchoscopy (P = .001). Propofol administered by a pediatric intensivist is a safe sedation technique in the pediatric outpatient setting.
