کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
5871970 | 1564711 | 2011 | 7 صفحه PDF | دانلود رایگان |
SummaryBackground & aimsTo investigate the effects of two different glucose infusions on glucose homeostasis and amino acid metabolism in post-surgical children.MethodsThis randomized crossover study evaluated glucose and amino acid metabolism in eight children (age 9.8 ± 1.9 months, weight 9.5 ± 1.1 kg) admitted to a pediatric intensive care unit in a tertiary university hospital after surgical correction for non-syndromal craniosynostosis. Patients were randomized to receive low (LG; 2.5 mg kgâ1 minâ1) and standard (SG; 5.0 mg kgâ1 minâ1) glucose infusion in a crossover setting. After a bolus (4 g kgâ1) of deuterium oxide, we conducted a primed, constant, 8 h tracer infusion with [6,6-2H2]Glucose, [1-13C]Leucine, [ring-2H5]Phenylalanine and [3,3-2H2]Tyrosine.ResultsSG resulted in hyperglycemia (defined as > 6.1 mmol Lâ1), while during LG plasma glucose levels were normoglycemic (5.9 ± 0.6 vs. 7.5 ± 1.7 mmol Lâ1; LG vs. SG respectively, p = 0.02). Hypoglycemia did not occur during LG infusion. Endogenous glucose production was not fully suppressed during the hyperglycemic state under SG and increased with reduced glucose infusion (2.6 ± 1.5 vs. 1.1 ± 1.4 mg kgâ1 minâ1; LG vs. SG; p = 0.05). Whole body protein balance derived from leucine and phenylalanine kinetics was slightly negative but not further affected with a decrease in glucose infusion.ConclusionsThe current recommended glucose infusion induces hyperglycemia in post-surgical children. A reduced glucose infusion safely reduced high glucose levels, while children were capable to sustain normoglycemia with increased endogenous glucose production. The reduced glucose infusion did not exacerbate the mild catabolic state in which the patients were.
Journal: Clinical Nutrition - Volume 30, Issue 6, December 2011, Pages 786-792