Effects of xylitol on carbohydrate and protein metabolism after trauma and during sepsis.

摘要: INTRODUCTION Total parenteral nutrition (TPN) after trauma and during sepsis has two major goals. One is the reduction of increased protein catabolism, second to avoid hyperglycemia enhanced hepatic gluconeogenesis. Glucose xylitol differ in their utilization rates sepsis. Whole-body glucose reduced such states, while more than doubled. In order investigate whether these differences are associated with beneficial effects on production sparing, we conducted animal clinical studies. METHODS For analysis turnover radioactive stable isotope techniques were applied. burned rats primed constant infusions 6-[3H]-glucose, 1-[14C]-alanine, 3-[14C]-alanine U-[14C]-acetate used determine whole body turnover, gluconeogenesis from C3-precursors alanine flux. septic nitrogen balance was calculated determination 24-hour-urine content measured by micro-Kjeldahl digestion. 24-hour urinary 3-methyl-histidine excretion analysed amino acid autoanalyser. human studies urea synthesis using continuous [6,6-d2]-glucose [2-N15]-urea, respectively. RESULTS first model demonstrated that hypocaloric contrast significantly C3-carbons. rat exchange calories a proportion 1:1 ameliorated retention lower excretion. surgical intensive care patients able confirm sparing properties xylitol. Hepatic infusion trauma, whereas equicaloric had no effects. led significant lactate concentrations isocaloric glucose. DISCUSSION as well mixture glucose/xylitol (1:1) efficient preserving alone. when compared During acute phase therefore recommend carbohydrate supplementation 3 g/kg BW/d long-term TPN dosage 6 recommended together acids and, if necessary, lipids.