Glucose response to abrupt initiation and discontinuation of total parenteral nutrition.

摘要: Plasma glucose was studied during the initiation of total parenteral nutrition (TPN) and discontinuation TPN without a tapering schedule. Blood sampled every 5 minutes for 2 hours after start 1 week later as discontinued. A 14 initiations discontinuations were in 18 patients. Severity illness patients ranged from stable condition postoperatively to multiple-system failure; six had diabetes mellitus. The solution 3:1 admixture that provided caloric intake equal 1.2 times resting energy expenditure, with 40% fat 60% carbohydrate calories. An average 1963 kcal per day (340 g glucose, 79 fat). During phase, mean increase plasma 60 mg/dL. diabetic +/- mg/dL compared 52 23 nondiabetics. decreased 40 20 mg/dL; two high concentrations regular insulin (50 100 units) showed an when stopped. returned preinfusion baseline discontinuation. both discontinuation, little change first minutes. No clinical symptoms hypoglycemia observed. In conclusion, can be safely started full support stopped abruptly response is rapid, predictable, mostly complete within