Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Apr;33(4):739-41.
doi: 10.2337/dc09-1748. Epub 2009 Dec 29.

Hyperglycemia during total parenteral nutrition: an important marker of poor outcome and mortality in hospitalized patients

Francisco J Pasquel  1 , Ronnie Spiegelman, Megan McCauley, Dawn Smiley, Denise Umpierrez, Rachel Johnson, Mary Rhee, Chelsea Gatcliffe, Erica Lin, Erica Umpierrez, Limin Peng, Guillermo E Umpierrez
Affiliations

Hyperglycemia during total parenteral nutrition: an important marker of poor outcome and mortality in hospitalized patients

Francisco J Pasquel et al. Diabetes Care. 2010 Apr.

Abstract

Objective: To determine the effect of total parenteral nutrition (TPN)-induced hyperglycemia on hospital outcome.

Research design and methods: The study determined whether blood glucose values before, within 24 h, and during days 2-10 of TPN are predictive of hospital complications and mortality.

Results: Subjects included a total of 276 patients receiving TPN for a mean duration of 15 +/- 24 days (+/-SD). In multiple regression models adjusted for age, sex, and diabetes status, mortality was independently predicted by pre-TPN blood glucose of 121-150 mg/dl (odds ratio [OR] 2.2, 95% CI 1.1-4.4, P = 0.030), 151-180 mg/dl (3.41, 1.3-8.7, P = 0.01), and >180 mg/dl (2.2, 0.9-5.2, P = 0.077) and by blood glucose within 24 h of >180 mg/dl (2.8, 1.2-6.8, P = 0.020). A blood glucose within 24 h of >180 mg/dl was associated with increased risk of pneumonia (OR 3.1, 95% CI 1.4-7.1) and acute renal failure (2.3, 1.1-5.0).

Conclusions: Hyperglycemia is associated with increased hospital complications and mortality in patients receiving TPN.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Mean blood glucose (BG) levels and mortality rate. □, blood glucose levels pre-TPN (BG Pre-TPN), P = 0.167. ■, blood glucose levels within 24 hours of TPN (BG-24h TPN), P = 0.004. ■, blood glucose levels during days 2–10 of TPN (BG D2–10 of TPN), P = 0.060.
See this image and copyright information in PMC

References

    1. Ziegler TR. Parenteral nutrition in the critically ill patient. N Engl J Med 2009;361:1088–1097 - PMC - PubMed
    1. Heyland DK, Montalvo M, MacDonald S, Keefe L, Su XY, Drover JW. Total parenteral nutrition in the surgical patient: a meta-analysis. Can J Surg 2001;44:102–111 - PubMed
    1. Perioperative total parenteral nutrition in surgical patients. The Veterans Affairs Total Parenteral Nutrition Cooperative Study Group. N Engl J Med 1991;325:525–532 - PubMed
    1. der Voort PH, Feenstra RA, Bakker AJ, Heide L, Boerma EC, der Horst IC. Intravenous glucose intake independently related to intensive care unit and hospital mortality: an argument for glucose toxicity in critically ill patients. Clin Endocrinol (Oxf) 2006;64:141–145 - PubMed
    1. Schloerb PR. Glucose in parenteral nutrition: a survey of U.S. medical centers. JPEN J Parenter Enteral Nutr 2004;28:447–452 - PubMed

Publication types