BACKGROUND & AIMS: To investigate the effects of glucose, parenteral amino acids, and intravenous insulin on albumin synthesis rates in critically ill children. METHODS:Two studies were performed in 8 post-surgical infants (age 9.8 ± 1.9 months; weight 9.5 ± 1.1 kg) and 9 septic adolescents (age 15 ± 1 yr; BMI 23 ± 4 kg m(-2)), respectively. All received a primed, constant, tracer infusion with [1-(13)C]Leucine. The infants in study 1 were randomized to receive low (2.5 mg kg(-1) min(-1)) and standard (5.0 mg kg(-1) min(-1)) glucose intake in a cross-over setting of two periods of 4 h each. The adolescents in study 2 were randomized to receive total parenteral nutrition with standard (1.5 g kg(-1) day(-1)) and high (3.0 g kg(-1) day(-1)) amino acid intake in a two day cross-over setting. On both study days, during the last 3 h of the tracer study, they received insulin infused at 80 mU m(-2) min(-1). RESULTS: The post-surgical infants and the septic adolescents were mildly hypoalbuminemic (∼2.5 g dL(-1)) with high synthesis rates, which were not affected by different intakes of glucose, amino acids, or insulin infusion. CONCLUSIONS:Albumin synthesis rates in hypoalbuminemic critically ill children are high but were not upregulated through nutrient supply, and in septic adolescents are unaffected by insulin.
RCT Entities:
BACKGROUND & AIMS: To investigate the effects of glucose, parenteral amino acids, and intravenous insulin on albumin synthesis rates in critically ill children. METHODS: Two studies were performed in 8 post-surgical infants (age 9.8 ± 1.9 months; weight 9.5 ± 1.1 kg) and 9 septic adolescents (age 15 ± 1 yr; BMI 23 ± 4 kg m(-2)), respectively. All received a primed, constant, tracer infusion with [1-(13)C]Leucine. The infants in study 1 were randomized to receive low (2.5 mg kg(-1) min(-1)) and standard (5.0 mg kg(-1) min(-1)) glucose intake in a cross-over setting of two periods of 4 h each. The adolescents in study 2 were randomized to receive total parenteral nutrition with standard (1.5 g kg(-1) day(-1)) and high (3.0 g kg(-1) day(-1)) amino acid intake in a two day cross-over setting. On both study days, during the last 3 h of the tracer study, they received insulin infused at 80 mU m(-2) min(-1). RESULTS: The post-surgical infants and the septic adolescents were mildly hypoalbuminemic (∼2.5 g dL(-1)) with high synthesis rates, which were not affected by different intakes of glucose, amino acids, or insulin infusion. CONCLUSIONS: Albumin synthesis rates in hypoalbuminemic critically illchildren are high but were not upregulated through nutrient supply, and in septic adolescents are unaffected by insulin.
Authors: Gabriel Dumitrescu; Andras Komaromi; Olav Rooyackers; Maria Klaude; Christina Hebert; Jan Wernerman; Åke Norberg Journal: PLoS One Date: 2017-03-28 Impact factor: 3.240
Authors: Carlijn T I de Betue; Sascha C A T Verbruggen; Henk Schierbeek; Shaji K Chacko; Ad J J C Bogers; Johannes B van Goudoever; Koen F M Joosten Journal: Crit Care Date: 2012-10-02 Impact factor: 9.097
Authors: Vincent G Geukers; Monique E Dijsselhof; Nicolaas J G Jansen; Johannes M P J Breur; Dewi van Harskamp; Henk Schierbeek; Johannes B van Goudoever; Albert P Bos; Hans P Sauerwein Journal: Nutr J Date: 2015-07-28 Impact factor: 3.271