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Intensive Care Medicine
Erschienen in: Intensive Care Medicine 12/2007

01.12.2007 | Original

The relationship between blood glucose control and intolerance to enteral feeding during critical illness

verfasst von: Nam Nguyen, Katrina Ching, Robert Fraser, Marianne Chapman, Richard Holloway

Erschienen in: Intensive Care Medicine | Ausgabe 12/2007

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Abstract

Objective

To assess the relationship between blood glucose concentrations (BSL) and intolerance to gastric feeding in critically ill patients.

Design

Prospective, case-controlled study.

Patients and participants

Two-hourly BSL and insulin requirements over the first 10 days after admission were assessed in 95 consecutive feed-intolerant (NG aspirate > 250 ml during feed) critically ill patients and 50 age-matched, feed-tolerant patients who received feeds for at least 3 days. Patients with diabetes mellitus were excluded. A standard insulin protocol was used to maintain BSL at 5.0–7.9 mmol.

Measurements and results

The peak BSLs were significantly higher before and during enteral feeding in feed-intolerant patients. The mean and trough BSLs were, however, similar between the two groups on admission, 24 h prior to feeding and for the first 4 days of feeding. The variations in BSLs over 24 h before and during enteral feeding were significantly greater in feed-intolerant patients. A BSL greater than 10 mmol/l was more prevalent in patients with feed intolerance during enteral feeding. The time taken to develop feed intolerance was inversely related to the admission BSL (r = –0.40). The amount of insulin administered before and during enteral feeding was similar between the two groups.

Conclusions

Feed intolerance in critically ill patients is associated with a greater degree of glycaemic variation, with a greater number of patients with transient hyperglycaemia. These data suggest more intensive insulin therapy may be required to minimize feed intolerance, an issue that warrants further study.
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Metadaten
Titel
The relationship between blood glucose control and intolerance to enteral feeding during critical illness
verfasst von
Nam Nguyen
Katrina Ching
Robert Fraser
Marianne Chapman
Richard Holloway
Publikationsdatum
01.12.2007
Verlag
Springer-Verlag
Erschienen in
Intensive Care Medicine / Ausgabe 12/2007
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-007-0869-7

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