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Genetic Contribution to Delirium in Mechanically Ventilated ICU Patients

Abstract

Delirium is a pervasive complication of critical illness that increases patient morbidity and mortality. This exploratory study examined associations between delirium, thiamine blood levels, genes associated with thiamine metabolism and other genes identified as having an association with delirium in critically ill patients.

Fifty mechanically ventilated ICU patients were enrolled in this prospective observational study between June 2009 and June 2010. Blood thiamine levels and delirium status were assessed daily. A blood sample for genotyping was obtained at baseline.

Thiamine blood levels are highly variable in critical illness; 56% of the variance in thiamine levels derives from differences between individuals. The remaining 44% of the variance comes from differences in the within-patient trajectory over days.

Whole blood thiamine levels were not asociated with delirium in critical illness. There was evidence of a genetic association with delirium. This study warrants replication with a larger number of pateints to validate this finding.

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