eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2024-03-15 12 3 38 41 10.12691/ajmcr-12-3-3 AJMCR20241233 article Dr. S. AlKaabi 1 Dr. R. Ebead 1 Dr. M. Khames Magdy.aly@msc.mil.ae 1 Dr. M. Amin 1 Dr. A. Gupta 1 Dr. E. Marzouk 1 Dr. S. Ahmed 1 ICU department Zayed Military Hospital Abu Dhabi, UAE This is a case of 54-years-old critically ill H1N1 ARDS patient with prolonged ventilation and sedation and difficult weaning from sedation and mechanical ventilation. The case gives spotlight on not uncommon cause of delirium and failure of weaning in critically ill patients which is Vitamin B1 deficiency and how it is underestimated and should be put in mind while management those patients. Delirium and the failure to wean patients off sedation and mechanical ventilation in intensive care units (ICUs) are significant challenges that healthcare providers frequently face. This issue became evident in a unique case involving a critically ill H1N1 ARDS patient aged 54, which highlighted the often-ignored cause of these complications - Vitamin B1 deficiency. This critical review aims to delve deeper into the role of Vitamin B1 deficiency in exacerbating the conditions of critically ill patients and argue why it should be a key consideration in patient management. https://pubs.sciepub.com/ajmcr/12/3/3/ajmcr-12-3-3.pdf Acute delirium acute confusion state thiamine deficiency encephalopathy sedation weaning ventilator weaning ICU critically ill