The DOI matches its Crossref record; 25 of the 25 references it cites were found in a registry or an index.
Effects of isoenergetic glucose-based or lipid-based parenteral nutrition on glucose metabolism, de novo lipogenesis, and respiratory gas exchanges in critically ill patients
Abstract
OBJECTIVE: To compare the effects of isocaloric, isonitrogenous carbohydrate nutrition vs. lipid-based total parenteral nutrition on respiratory gas exchange and intermediary metabolism in critically ill patients. DESIGN: Prospective, clinical trial. SETTING: Surgical intensive care unit in a major university hospital in Switzerland. PATIENTS: Sixteen patients admitted to the surgical intensive care unit. INTERVENTIONS: Patients were randomized to receive isocaloric isonitrogenous total parenteral nutrition (TPN) containing 75% (TPN-glucose) or 15% (TPN-lipid) glucose over a 5-day period. MEASUREMENTS AND MAIN RESULTS: Indirect glucose metabolism was assessed from plasma carbon-13 (13C)-labeled glucose and 13C-labeled CO2 production during a tracer infusion of uniformly 13C-labeled glucose, and de novo lipogenesis was estimated from the incorporation of 13C into palmitate-very low density lipoproteins (VLDL) during a tracer infusion of 1-(13)C acetate. Compared with TPN-lipid, TPN-glucose increased plasma glucose more (by 26% vs. 7%, p < .05), increased insulin more (by 284% vs. 40%, p < .01), and increased total CO2 more (by 15% vs. 0%, p < .01). Both nutrient mixtures failed to inhibit endogenous glucose production and net protein oxidation, suggesting absence of suppression of gluconeogenesis. Fractional de novo lipogenesis was markedly increased by TPN-glucose to 17.4% vs. 3.3% with TPN lipids. CONCLUSIONS: The rate of glucose administration commonly used during TPN of critically ill patients does not suppress endogenous glucose production or net protein loss, but markedly stimulates de novo lipogenesis and CO2 production. Increasing the proportion of fat may be beneficial, provided that lipid emulsion has no adverse effects.
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“Both drugs have also been shown to be efficacious for elevated gastric residuals in an earlier meta-analysis not limited to critically ill patients (114).”
From ESPEN guideline on clinical nutrition in the intensive care unit. (2019) · cites this paper as [114]
In the citing paper
“Excessive glucose based energy provision is associated with hyperglycemia, enhanced CO 2 production, enhanced lipogenesis, increased insulin requirements and no advantage in protein sparing in comparison with lipid based energy provision [69].”
From ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit (2023) · cites this paper as [69]
Citations
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Metadata
- Authors
- Tappy, L., Schwarz, J.-M., Schneiter, P., Cayeux, C., Revelly, J.-P., Fagerquist, C. K., Jequier, E., & Chiolero, R.
- Affiliations
- Centre Hospitalier Universitaire Vaudois (CH)
- Venue
- Critical Care Medicine
- Published
- 1998-05
- Volume
- 26
- Issue
- 5
- Pages
- 860-867
- ISSN
- 0090-3493 (ISSN-L)
- OpenAlex
- W2011859447
- Cited by
- 211
- References
- 25
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 12 · 2023: 18 · 2022: 4 · 2021: 9 · 2020: 9 · 2019: 9 · 2018: 9 · 2017: 6 · 2016: 7 · 2015: 9 · 2014: 6 · 2013: 4 · 2012: 3
- FWCI
- 6.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Critical Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- IRIS (submittedVersion)
- SERVAL (Université de Lausanne) (submittedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Health Sciences › Nursing › Nutrition and Dietetics › Muscle metabolism and nutrition
- Keywords
- total parenteral nutrition, critically ill patients, glucose metabolism, de novo lipogenesis, pulmonary gas exchange, gluconeogenesis, protein oxidation, insulin, lipid emulsions, surgical intensive care unit
- MeSH terms
- Adolescent, Adult, Aged, Calorimetry, Indirect, Carbon Dioxide, Female, Glucose, Humans, Intensive Care Units, Lipids, Male, Middle Aged, Oxygen Consumption, Parenteral Nutrition, Pulmonary Gas Exchange, Wounds and Injuries, Injury Severity Score, Critical Illness
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