Hyperglycemia parenteral nutrition

McCowen KC, Friel C, Sternberg J, Chan S, Forse RA, Burke PA, Bistrian BR. Hypocaloric total parenteral nutrition effectiveness in prevention of hyperglycemia and infectious complications—a randomized clinical trial. Crit Care Med 2000 28(11) 3606-11. 

Why is it important to monitor for hyperglycemia when initiating parenteral nutrition support therapy The pancreas may not have time to adjust to the hypertonic dextrose solution, which is high in glucose. Hyperglycemia is usually temporary and dissipates once the pancreas adjusts. 

When can hyperglycemia persists in parenteral nutrition support therapy ... 

Rosemarin DK, Wardlaw GM, Mirtallo JM. Hyperglycemia associated with high, continuous infusion rates of total parenteral nutrition dextrose. Nutr Clin Pract 1996 11 151-156. 

McMahon MM. Management of parenteral nutrition in acutely ill patients with hyperglycemia. Nutr Clin Pract 2004 19 120-128. 

Chromium deficiency symptoms have been clearly identified in patients receiving total parenteral nutrition (TPN) without chromium. One patient who had received TPN for 31/2 years developed symptoms of hyperglycemia, weight loss, ataxia and peripheral neuropathy. When chromium... 

Pasquel FJ, Spiegelman R, McCauley M, Smiley D, Umpierrez D, Johnson R, Rhee M, Gatcliffe C, Lin E, Umpierrez E, Peng L, Umpierrez GE. Hyperglycemia during total parenteral nutrition an important marker of poor outcome and mortality in hospitalized patients. Diabetes Care 2010 33(4) 739 1. 

Olveira G, Tapia MJ, Oc6n J, Cabrejas-Gomez C, BaUesteros-Pomar MD, Vidal-Casariego A, et al. Parenteral nutrition-associated hyperglycemia in non-critically ill inpatients increases the risk of in-hospital mortality (multicenter study). Diabetes Care May 2013 36(5) 1061-6. 

Comparative studies In a systematic review of five randomized controlled comparisons of parenteral and enteral nutrition in patients with acute pancreatitis, there was diarrhea in 6 of 92 patients (7%) versus 24 of 82 (29%) respectively and hyperglycemia in 21 of 92 patients (23%) versus 7 of 82 (11%) [18 ]. The added risk of infections... 

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