Parenteral nutrition: A clear and present danger unabated by tight glucose control

Kazuhide Matsushima, Alan Cook, Tracy Tyner, Lauren Tollack, Richard Williams, Susan Lemaire, Randall S Friese, Heidi Frankel

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: The infectious risks of parenteral nutrition (PN) in critical illness are well described, although most literature predates tight glucose control (TGC) practice. The authors hypothesized that PN-related complications are ameliorated by TGC and are equivalent to those in enteral nutrition (EN) patients. Methods: A prospective cohort study of patients admitted to the surgical intensive care unit was conducted, comparing PN and EN patients. TGC target was 80 to 110 mg/dL. Univariate and multivariate logistic regression was used to explore the association between infectious outcomes and PN use. Results: One hundred fifty-five patients were studied. Mean daily glucose values were lower for the PN group than for the EN patients (118.2 vs 125.6 mg/dL, P = .002). Nonetheless, the incidence of bloodstream infection and catheter-related bloodstream infection was significantly associated with the administration of PN. In a multivariate logistic regression model, PN was associated with a >4-fold increase in the odds of having a catheter-related bloodstream infection (odds ratio, 4.48; 95% confidence interval, 1.1417.49; P = .03). Conclusions: Despite the successful implementation of TGC, PN is still a significant risk factor for infectious complications among surgical intensive care unit patients.

Original languageEnglish (US)
Pages (from-to)386-390
Number of pages5
JournalAmerican Journal of Surgery
Volume200
Issue number3
DOIs
StatePublished - Sep 2010
Externally publishedYes

Fingerprint

Parenteral Nutrition
Glucose
Enteral Nutrition
Catheter-Related Infections
Logistic Models
Critical Care
Intensive Care Units
Prednisolone
Critical Illness
Cohort Studies
Odds Ratio
Prospective Studies
Confidence Intervals
Incidence
Infection

Keywords

  • Critically ill patient
  • Nosocomial infection
  • Tight glucose control
  • Total parenteral nutrition

ASJC Scopus subject areas

  • Surgery

Cite this

Matsushima, K., Cook, A., Tyner, T., Tollack, L., Williams, R., Lemaire, S., ... Frankel, H. (2010). Parenteral nutrition: A clear and present danger unabated by tight glucose control. American Journal of Surgery, 200(3), 386-390. https://doi.org/10.1016/j.amjsurg.2009.10.023

Parenteral nutrition : A clear and present danger unabated by tight glucose control. / Matsushima, Kazuhide; Cook, Alan; Tyner, Tracy; Tollack, Lauren; Williams, Richard; Lemaire, Susan; Friese, Randall S; Frankel, Heidi.

In: American Journal of Surgery, Vol. 200, No. 3, 09.2010, p. 386-390.

Research output: Contribution to journalArticle

Matsushima, K, Cook, A, Tyner, T, Tollack, L, Williams, R, Lemaire, S, Friese, RS & Frankel, H 2010, 'Parenteral nutrition: A clear and present danger unabated by tight glucose control', American Journal of Surgery, vol. 200, no. 3, pp. 386-390. https://doi.org/10.1016/j.amjsurg.2009.10.023
Matsushima, Kazuhide ; Cook, Alan ; Tyner, Tracy ; Tollack, Lauren ; Williams, Richard ; Lemaire, Susan ; Friese, Randall S ; Frankel, Heidi. / Parenteral nutrition : A clear and present danger unabated by tight glucose control. In: American Journal of Surgery. 2010 ; Vol. 200, No. 3. pp. 386-390.
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