Hyperglycemia During Total Parenteral Nutrition
نویسندگان
چکیده
OBJECTIVE To determine the effect of total parenteral nutrition (TPN)-induced hyperglycemia on hospital outcome. RESEARCH DESIGN AND METHODS The study determined whether blood glucose values before, within 24 h, and during days 2-10 of TPN are predictive of hospital complications and mortality. RESULTS Subjects included a total of 276 patients receiving TPN for a mean duration of 15 +/- 24 days (+/-SD). In multiple regression models adjusted for age, sex, and diabetes status, mortality was independently predicted by pre-TPN blood glucose of 121-150 mg/dl (odds ratio [OR] 2.2, 95% CI 1.1-4.4, P = 0.030), 151-180 mg/dl (3.41, 1.3-8.7, P = 0.01), and >180 mg/dl (2.2, 0.9-5.2, P = 0.077) and by blood glucose within 24 h of >180 mg/dl (2.8, 1.2-6.8, P = 0.020). A blood glucose within 24 h of >180 mg/dl was associated with increased risk of pneumonia (OR 3.1, 95% CI 1.4-7.1) and acute renal failure (2.3, 1.1-5.0). CONCLUSIONS Hyperglycemia is associated with increased hospital complications and mortality in patients receiving TPN.
منابع مشابه
Predictive factors of hyperglycemia in hospitalized adults receiving total parenteral nutrition.
OBJECTIVE To know those predictive factors of hyperglycemia that could guide us the design of a parenteral nutrition and it could avoid later complications associated with it. Methods: A prospective observational study was designed; adult hospitalized patients who received total parenteral nutrition at least 48 hours were included. Nutritional and pharmacotherapeutic follow-up were performed ...
متن کاملHyperglycemia and antibody titres against heat shock protein 27 in traumatic brain injury patients on parenteral nutrition
Objective(s):Hyperglycemia worsens the neuronal death induced by cerebral ischemia. Previous studies demonstrated that diabetic hyperglycemia suppressed the expression of heat shock protein 70 and 60 (HSP70 and 60) in the liver. IgG antibody titres against heat shock protein 27 (anti HSP27) were measured to determine whether hyperglycemia exacerbates ischemic brain damage by suppressing the exp...
متن کاملThe effect of L-alanyl-L-glutamine dipeptide supplemented total parenteral nutrition on infectious morbidity and insulin sensitivity in critically ill patients.
OBJECTIVE The aim of this study was to assess the clinical efficacy of alanine-glutamine dipeptide-supplemented total parenteral nutrition defined by the occurrence of nosocomial infections. Secondary parameters included Sequential Organ Failure Assessment score, hyperglycemia and insulin needs, intensive care unit and hospital length of stay, and 6-month mortality. DESIGN Multicenter, prospe...
متن کاملThe risk for bloodstream infections is associated with increased parenteral caloric intake in patients receiving parenteral nutrition
BACKGROUND Patients receiving total parenteral nutrition (TPN) are at high risk for bloodstream infections (BSI). The notion that intravenous calories and glucose lead to hyperglycemia, which in turn contributes to BSI risk, is widely held but is unproven. We therefore sought to determine the role that hyperglycemia and parenteral calories play in the development of BSI in hospitalized patients...
متن کاملHyperglycemia is associated with adverse outcomes in patients receiving total parenteral nutrition.
OBJECTIVE Hyperglycemia is associated with poor clinical outcomes and mortality in myocardial infarction, stroke, and general hospital patients. However, there are few data regarding the effect of hyperglycemia on outcomes in patients receiving total parenteral nutrition (TPN), a therapy that predisposes patients to hyperglycemia. The aim of this study was to determine whether elevated blood gl...
متن کامل