Efficacy of a high-carbohydrate diet in catabolic illness

Hart, David K.; Wolf, Steven E.; Zhang, Xiaojun; Chinkes, David L.; Buffalo, Michael C.; Matin, Sina; DebRoy, Meelie; Wolfe, Robert R.; Herndon, David N.

doi:10.1097/00003246-200107000-00004

Cited by 107 publications

(63 citation statements)

References 19 publications

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“…fat synthesis from glucose), a metabolically undesirable energy-consuming process. Paradoxically, this contrasts with the ability of high glucose regimens to spare protein losses in burned patients receiving hyper-caloric feeding [24]. Whilst fat is present in nutrition formulas primarily to provide essential fatty acids that cannot be synthesised in humans, there is also reasonable evidence that, during iso-caloric feeding, fatty acids and carbohydrates exert an equally protein-sparing effect [20].…”

Section: Fat and Glucosementioning

confidence: 99%

Nutritional papers in ICU patients: what lies between the lines?

Preiser

Chioléro²,

Wernerman

2002

Intensive Care Med

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The abundance of literature related to nutritional support reflects its recently recognised role in preventing metabolic complications and gut dysfunction during critical illness. However, some published studies lack relevance to critically ill patients, as a result of the selection of subjects and outcome variables, or flaws in the study design, as well as in the type, composition, timing, route of administration and amount of nutritional support given. This review will highlight these confounding factors by describing two imaginary (but typical) clinical trials and by analysing some studies published. The point at issue is that basic quality requirements, such as the formulation of a prospective hypothesis and the delineation of the effects of the reference treatment, are often lacking in many studies published. Data analysis was often found to be biased by the absence of statistical power calculation and intention-to-treat analysis. Globally, studies designed to assess the effects of nutritional support on the outcome of critically ill patients, rarely fulfil basic quality requirements and should therefore be interpreted cautiously. We suggest simple strategies or study design that will allow important questions to be answered by future clinical trials.

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Section: Fat and Glucosementioning

confidence: 99%

Nutritional papers in ICU patients: what lies between the lines?

Preiser

Chioléro²,

Wernerman

2002

Intensive Care Med

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“…The nitrogen sparing effects of glucose and lipid have been addressed in several reports with conflicting results. Some studies have found glucose achieves better nitrogen retention than lipids [15][16][17] , but usually there is no benefit of one fuel source over the other [18][19][20] . A review of the literature by Iapichino et al [21] , attempted to consider the potential confounding factors, and then compare the effects of glucose alone with the glucose-fat mixed system upon protein metabolism.…”

Section: Discussionmentioning

confidence: 99%

Hypocaloric peripheral parenteral nutrition with lipid emulsion in postoperative gastrointestinal cancer patients

Chuang²,

Yu³

et al. 2010

WJGO

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AIM:To investigate the use of lipid emulsion substituting for glucose in postoperative hypocaloric peripheral parenteral nutrition (HPPN). METHODS:This prospective, randomized study was conducted on 20 postoperative gastrointestinal cancer patients. They were randomized and equally divided into interventional group and control group, and both were administered isocaloric and isonitrogenous diets with for lipid emulsion substituting for partial glucose loads in the interventional group. RESULTS:Nutritional parameters and biochemical data were compared between the two groups before and after 6-d of HPPN. Most investigated variables showed no significant changes after administration of HPPN with lipid emulsion. However, the postoperative triglyceride level was significantly lower in the interventional group than in the control group (P < 0.05). In comparison with lipid emulsion, glucose administration resulted in less decrease in postoperative prealbumin level (P < 0.05). CONCLUSION:In addition to supplementing with essential fatty acid, it seems that HPPN with lipid emulsion is well-tolerated and beneficial to postoperative gastrointestinal cancer patients.

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“…EN was initiated at 20 mL/h and then increased by 20 mL/h every 4 h as tolerated until the goal rate was reached. The Carlson and Milner equations were used to predict calorie expenditure [13,14]. The Milner equation was created for >30 days after injury, with the factor of number of days post burn added to the Carlson equation using linear regression [14].…”

Section: Methodsmentioning

confidence: 99%