Total parenteral nutrition–associated hyperglycemia correlates with prolonged mechanical ventilation and hospital stay in septic infants

Alaedeen, Diya; Walsh, Michele C.; Chwals, Walter J.

doi:10.1016/j.jpedsurg.2005.10.045

Cited by 89 publications

(74 citation statements)

References 31 publications

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“…(20) Because of sedation and mechanical ventilation, the calorie needs of PICU patients may be less than estimated, and overfeeding can increase the need for mechanical ventilation, the risk of infection, and the length of the PICU stay. (22,23) Early nutrition has been suggested to suppress autophagy, (24,25) which is an important protective mechanism of cells in situations of increasing oxidative stress and inflammation. However, this response may eventually fail, with the patient progressing to malnutrition.…”

Section: Discussionmentioning

confidence: 99%

Effects of enteral nutrition on clinical outcomes among mechanically ventilated and sedated patients in the pediatric intensive care unit

Tripathi

Kaur²,

Varayil³

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Effects of enteral nutrition on clinical outcomes among mechanically ventilated and sedated patients in the pediatric intensive care unit

Tripathi

Kaur²,

Varayil³

et al. 2015

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“…Elevated blood glucose levels (BG) (Hyperglycaemia) is a common complication of prematurity and stress in neonatal intensive care, and while definitions and thresholds vary [11], studies show that 30-70% of very/extremely low birth weight infants have at least one BG> 8 mmol/L [12][13][14][15][16]. Hyperglycaemia is associated with increased mortality [15][16][17], and morbidity/complications in this cohort [15][16][17][18][19][20][21], but there is still debate over whether hyperglycaemia causes increased morbidity, or is reflective of worsened condition.…”

Section: Introductionmentioning

confidence: 98%

Insulin kinetics and the Neonatal Intensive Care Insulin–Nutrition–Glucose (NICING) model

Dickson

Pretty

Alsweiler

et al. 2017

Mathematical Biosciences

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Background: Models of human glucose-insulin physiology have been developed for a range of uses, with similarly different levels of complexity and accuracy. STAR (Stochastic Targeted) is a modelbased approach to glycaemic control. Elevated blood glucose concentrations (hyperglycaemia) are a common complication of stress and prematurity in very premature infants, and have been associated with worsened outcomes and higher mortality. This research identifies and validates the model parameters for model-based glycaemic control in neonatal intensive care.

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“…Hyperglycaemia has been linked to worsened outcomes. Associated morbidities include osmotic diuresis, electrolyte imbalance, intraventricular haemorrhage, sepsis, and increased ventilator dependence, retinopathy of prematurity, hospital length of stay and mortality [2][3][4][5][7][8][9]. High rates of proteolysis are also common in low birth weight infants, reducing muscle mass and inhibiting growth [10].…”

Section: Introductionmentioning

confidence: 99%

Development of blood glucose control for extremely premature infants

Compte

Chase

Lynn

et al. 2011

Computer Methods and Programs in Biomedicine

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Abstract:Extremely premature neonates often experience hyperglycaemia, which has been linked to increased mortality and worsened outcomes. Insulin therapy can assist in controlling blood glucose levels and promoting needed growth. This study presents the development of a model-based stochastic targeted controller designed to adapt insulin infusion rates to match the unique and changing metabolic state and control parameters of the neonate. Long-term usage of targeted BG control requires successfully forecasting variations in neonatal metabolic state, accounting for differences in clinical practices between units, and demonstrating robustness to errors that can occur in everyday clinical usage. Simulation studies were used to evaluate controller ability to target several common BG ranges and evaluate controller sensitivity to missed BG measurements and delays in control interventions on a virtual patient cohort of 25 infants developed from retrospective data. Initial clinical pilot trials indicated model performance matched expected performance from simulations. Stochastic targeted glucose control developed using validated patient-specific virtual trials can yield effective protocols for this cohort. Long-term trials show fundamental success, however clinical interface design appears as a critical factor to ensuring good compliance and thus good control.3

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Total parenteral nutrition–associated hyperglycemia correlates with prolonged mechanical ventilation and hospital stay in septic infants

Cited by 89 publications

References 31 publications

Effects of enteral nutrition on clinical outcomes among mechanically ventilated and sedated patients in the pediatric intensive care unit

Effects of enteral nutrition on clinical outcomes among mechanically ventilated and sedated patients in the pediatric intensive care unit

Insulin kinetics and the Neonatal Intensive Care Insulin–Nutrition–Glucose (NICING) model

Development of blood glucose control for extremely premature infants

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