Lactic acidosis traced to thiamine deficiency related to nationwide shortage of multivitamins for total parenteral nutrition -- United States, 1997

MMWR Morb Mortal Wkly Rep. 1997 Jun 13;46(23):523-8.


Since November 1996, there has been a nationwide shortage of intravenous (IV) multivitamins (MVIs) used in U.S. hospitals and home-health-care agencies for total parenteral nutrition (TPN). Patients receiving TPN without MVI supplementation are at risk for thiamine deficiency and life-threatening complications associated with severe deficiency of thiamine, a coenzyme necessary for oxidation of keto acids (Figure 1). This report describes three patients receiving TPN who had thiamine deficiency-related lactic acidosis in 1997 and presents recommendations for alternatives to parenteral MVI during the shortage.

Publication types

  • Case Reports

MeSH terms

  • Acidosis, Lactic / etiology*
  • Adult
  • Child
  • Female
  • Humans
  • Male
  • Parenteral Nutrition, Total*
  • Thiamine Deficiency / complications*
  • Thiamine Deficiency / prevention & control
  • United States
  • Vitamins / supply & distribution*


  • Vitamins