Intravenous multivitamins ('banana bags') for emergency patients who may have nutritional deficits

摘要

Malnutrition is frequently exhibited in the alcoholic and affects both morbidity and mortality. The prevalences of vitamin deficiency states in an inpatient group admitted through the emergency department (ED) in the United Kingdom were 21%, 2.7%, and 32% for thiamine, riboflavin, and pyridoxine, respectively, with 49.2% deficient in one or more vitamins. Other studies indicate that approximately 30% to 80% and 60% of alcoholic patients are thiamine and folate deficient, respectively.3' However, recognition is difficult because "the classic signs of vitamin deficiency only occur in states of extreme depletion and are unreliable indicators for early treatment or prophylaxis .. . postmortem findings reveal that thiamine (vitamin Bl) deficiency sufficient to cause irreversible brain damage is not diagnosed ante mortem in 80-90% of patients."5 Thus, the emergency physician must maintain both a high level of suspicion and low threshold to treat poor nutritional states in the alcoholic patient.