Hyperglycemia and hypoalbuminemia as prognostic mortality factors in patients with enteral feeding

Infantino, Carlos Alfredo González; González, Claudio; Sanchez, R. Garcia; Presner, Natalia

doi:10.1016/j.nut.2012.07.019

Cited by 22 publications

(26 citation statements)

References 23 publications

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“…The mean Charlson Comorbidity Index score was higher in the closed-loop group than in the control group (appendix). Total hospital stay was longer in the control group (median 32 days [IQR 25-47]) than in the closedloop group (18 days [14-26]; p=0•013); however, length of hospital stay from study enrolment to discharge was similar between groups (15 days in the control group vs 10 days [6][7][8][9][10][11][12][13][14][15][16][17][18][19] in the closed-loop group; p=0•13).…”

Section: Resultsmentioning

confidence: 99%

“…Hyperglycaemia occurring in inpatients receiving parenteral or enteral nutrition, with or without a history of diabetes, is associated with increased morbidity and mortality. [4][5][6] Observational studies 4,5,7-9 have shown that the risks of infection, cardiac complications, acute renal failure, respiratory failure, and mortality increase as mean blood glucose increases in patients receiving parenteral nutrition.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Use of metformin to treat pregnant women with polycystic ovary syndrome (PregMet2): a randomised, double-blind, placebo-controlled trial

Løvvik

Carlsen

Salvesen

et al. 2019

The Lancet Diabetes & Endocrinology

133

147

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Background Glucose management is challenging in patients who require nutritional support in hospital. We aimed to assess whether fully closed-loop insulin delivery would improve glycaemic control compared with conventional subcutaneous insulin therapy in inpatients receiving enteral or parenteral nutrition or both. Methods We did a two-centre (UK and Switzerland), open-label, randomised controlled trial in adult inpatients receiving enteral or parenteral nutrition (or both) who required subcutaneous insulin therapy. Patients recruited from non-critical care surgical and medical wards were randomly assigned (1:1) using a computer-generated minimisation schedule (stratified by type of nutritional support [parenteral nutrition on or off] and pre-study total daily insulin dose [<50 or ≥50 units]) to receive fully closed-loop insulin delivery with faster-acting insulin aspart (closed-loop group) or conventional subcutaneous insulin therapy (control group) given in accordance with local clinical practice. Continuous glucose monitoring in the control group was masked to patients, ward staff, and investigators. Patients were followed up for a maximum of 15 days or until hospital discharge. The primary endpoint was the proportion of time that sensor glucose concentration was in target range (5•6-10•0 mmol/L), assessed in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, number NCT01774565.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Use of metformin to treat pregnant women with polycystic ovary syndrome (PregMet2): a randomised, double-blind, placebo-controlled trial

Løvvik

Carlsen

Salvesen

et al. 2019

The Lancet Diabetes & Endocrinology

133

147

View full text Add to dashboard Cite

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“…Gonzalez‐Infantino et al 33 observed that NDH increased morbidity and mortality in addition to extending the length of time that patients required EN. Furthermore, patients were less likely to be weaned to oral feedings since only 20% of NDH patients transitioned to oral feedings during a 2‐week period compared with 60% of patients with normal glucose levels 33 . A contributing factor to NDH is the delivery of EN and parenteral nutrition (PN) support, which contains both glucose and glucogenic components 6 .…”

Section: Enteral Nutritionmentioning

confidence: 99%

Management of Hyperglycemia and Enteral Nutrition in the Hospitalized Patient

2015

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There has been increased attention on the importance of identifying and distinguishing the differences between stress-induced hyperglycemia (SH), newly diagnosed hyperglycemia (NDH), and hyperglycemia in persons with established diabetes mellitus (DM). Inpatient blood glucose control is now being recognized as not only a cost issue for hospitals but also a concern for patient safety and care. The reasons for the increased incidence of hyperglycemia in hospitalized patients include preexisting DM, undiagnosed DM or prediabetes, SH, and medication-induced hyperglycemia with resulting transient blood glucose variability. It is clear that identifying and documenting hyperglycemia in hospitalized patients with and without a previous diagnosis of DM and initiating prompt insulin treatment are important. Agreement on the optimum treatment goals for hyperglycemia remains quite controversial, and the benefits of intensive glucose management may be lost at the cost of hypoglycemia in intensive care unit patients. Nutrition support in the form of enteral nutrition (EN) increases the risk of hyperglycemia in both critical and non-critically ill hospitalized patients. Reasons for beginning a tube feeding are the same whether a person has NDH or DM. What differs is how to incorporate EN into the established insulin management protocols. The risk for hyperglycemia with the addition of EN is even higher in those without a previous diagnosis of DM. This review discusses the incidence of hyperglycemia, the pathogenesis of hyperglycemia, factors contributing to hyperglycemia in the hospitalized patient, glycemic management goals, current glycemic management recommendations, and considerations for EN formula selection, administration, and treatment.

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“…Studies had found that the decreasing of serum albumin levels often indicated poor prognosis towards critically ill patients. [7][8][9] So, how to prevent and treat hypoalbuminemia had been a focus of the study, the administration of exogenous albumin seemed very reasonable to correct hypoalbuminemia, but there existed a lot of controversy in clinical practices that whether the infusion of exogenous albumin towards patients with hypoalbuminemia could improve their prognosis. Hydroxyethyl starch 130/0.4 (HES) was the thirdgeneration artificial colloid applied clinically, and its roles in preventing microvascular albumin leakage had obtained more and more attentions from researchers.…”

Section: ■ Introductionmentioning

confidence: 99%

Impacts of albumin synergized with hydroxyethyl starch on early microvascular albumin leakage after major abdominal surgery in rabbits

Cen

et al. 2017

Acta Cir. Bras.

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Impacts of albumin synergized with hydroxyethyl starch on early microvascular albumin leakage after major abdominal surgery in rabbits 1 3-Experimental SurgeryActa Cir Bras. 2017;32(2):108-115 AbstractPurpose: To investigate the impacts of albumin synergized with hydroxyethyl starch (HES) on early microvascular albumin leakage after major abdominal surgery in rabbits. Methods: Forty male Japanese rabbits were randomly divided into four groups: the control group, the saline group, the albumin group, and the Syn group (hydroxyethyl starch+albumin). The latter three groups were performed gastrectomy plus resection of pancreatic body and tail and splenectomy. The serum albumin concentration was detected before and 48h after surgery, and the conditions of mesenteric microvascular leakage in these 4 groups were observed under microscope 48 h after surgery to calculate the leakage rate. Results: Compared with the saline group, the albumin group and the Syn group exhibited significantly increased serum albumin concentrations 48h after surgery (P<0.05). The albumin leakage rate was the most obvious in the albumin group, followed by the saline group, while that in the Syn group was the minimal, and there existed significant differences among these groups (P<0.05). Conclusion:Simple administration of albumin in the early stage after major abdominal surgery could increase the albumin leakage, while the synergization of albumin and hydroxyethyl starch could reduce the albumin leakage.

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Hyperglycemia and hypoalbuminemia as prognostic mortality factors in patients with enteral feeding

Cited by 22 publications

References 23 publications

Use of metformin to treat pregnant women with polycystic ovary syndrome (PregMet2): a randomised, double-blind, placebo-controlled trial

Use of metformin to treat pregnant women with polycystic ovary syndrome (PregMet2): a randomised, double-blind, placebo-controlled trial

Management of Hyperglycemia and Enteral Nutrition in the Hospitalized Patient

Impacts of albumin synergized with hydroxyethyl starch on early microvascular albumin leakage after major abdominal surgery in rabbits

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