Muna Alchaer1, Rawia Khasawneh1, Rochelle Heuberger1, Susan Hewlings1. 1. Nutrition and Dietetics Program, School of Rehabilitation and Medical Sciences, The Herbert H. & Grace A. Dow College of Health Professions, Central Michigan University, Mount Pleasant, Michigan, USA.
Abstract
Background: Total parenteral nutrition (TPN) provides full nutrition support to critically ill patients with an impaired digestive tract. Patients who receive TPN support are at higher risk for complications such as hyperglycemia. In our study, we aim to assess the prevalence of hyperglycemia induced by TPN and identify its risk factors in hospitalized adult patients. Methods: Patients who received TPN between January 2012 and December 2017 at University of Pittsburgh Medical Center-St. Margaret hospital were retrospectively screened. TPN-induced hyperglycemia was confirmed whether blood glucose was ≥180 mg/dL at any point, from the time of TPN initiation until 1-day post TPN termination. Characteristics of the hyperglycemia and the nonhyperglycemia groups were analyzed to predict potential risk factors. Results: A total of 197 patients were screened, 55 were excluded (1 died, 37 diabetic, and 17 had elevated blood glucose before TPN), and 142 patients were included, 42 of them (29.6%) developed hyperglycemia following TPN administration. Duration of TPN, surgical indications, and obesity were significantly higher in the hyperglycemia group. Additionally, age and steroids use were independent predictors of hyperglycemia in TPN patients after applying multivariable logistic regression model on our sample. Conclusions: Hyperglycemia is common after TPN. Risk factors assessment may help optimizing glycemic control in higher risk individuals to improve their outcomes. These include patients with obesity, surgical indication of TPN, and longer duration of TPN.
Background: Total parenteral nutrition (TPN) provides full nutrition support to critically illpatients with an impaired digestive tract. Patients who receive TPN support are at higher risk for complications such as hyperglycemia. In our study, we aim to assess the prevalence of hyperglycemia induced by TPN and identify its risk factors in hospitalized adult patients. Methods:Patients who received TPN between January 2012 and December 2017 at University of Pittsburgh Medical Center-St. Margaret hospital were retrospectively screened. TPN-induced hyperglycemia was confirmed whether blood glucose was ≥180 mg/dL at any point, from the time of TPN initiation until 1-day post TPN termination. Characteristics of the hyperglycemia and the nonhyperglycemia groups were analyzed to predict potential risk factors. Results: A total of 197 patients were screened, 55 were excluded (1 died, 37 diabetic, and 17 had elevated blood glucose before TPN), and 142 patients were included, 42 of them (29.6%) developed hyperglycemia following TPN administration. Duration of TPN, surgical indications, and obesity were significantly higher in the hyperglycemia group. Additionally, age and steroids use were independent predictors of hyperglycemia in TPN patients after applying multivariable logistic regression model on our sample. Conclusions: Hyperglycemia is common after TPN. Risk factors assessment may help optimizing glycemic control in higher risk individuals to improve their outcomes. These include patients with obesity, surgical indication of TPN, and longer duration of TPN.
Authors: Cesar Augusto Flores Dueñas; Soila Maribel Gaxiola Camacho; Martin Francisco Montaño Gómez; Rafael Villa Angulo; Idalia Enríquez Verdugo; Tomás Rentería Evangelista; José Ascención Pérez Corrales; Miguel Ángel Rodríguez Gaxiola Journal: Ir Vet J Date: 2021-06-03 Impact factor: 2.146