Thiamine deficiency may occur in critically ill patients in case of increased glucose metabolism (i.e., in septic states or post-surgical phases), sudden or aggressive nutrition delivery to malnourished patients (refeeding syndrome), or excessive removal (as during continuous renal replacement therapy, especially in case of high-dose prescription). Pediatric critically ill patients, especially in case of infection, have shown a thiamine deficiency incidence of about 25% upon ICU admission. In any case, to avoid lactic acidosis secondary to thiamine deficiency, adequate supplementation with parenteral or enteral nutrition is crucial.

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