Hypoglycemia During the Temporary Interruption of Parenteral Nutrition Infusion in Pediatric Hematopoietic Stem Cell Transplantation

被引:1
作者
Yanagisawa, Ryu [1 ,2 ]
Takeuchi, Kouichi [3 ]
Komori, Kazutoshi [1 ,2 ]
Fujihara, Ikuko [1 ]
Hidaka, Yoshihiko [2 ]
Morita, Daisuke [2 ]
Futatsugi, Akiko [4 ]
Ono, Takako [4 ]
Hidaka, Eiko [4 ,5 ]
Sakashita, Kazuo [1 ,2 ]
Shiohara, Masaaki [6 ]
机构
[1] Nagano Childrens Hosp, Dept Hematol Oncol, 3100 Toyoshina, Azumino, Nagano 3998288, Japan
[2] Shinshu Univ, Dept Pediat, Sch Med, Matsumoto, Nagano, Japan
[3] Nagano Childrens Hosp, Dept Gen Pediat, Azumino, Japan
[4] Nagano Childrens Hosp, Dept Lab Med, Azumino, Japan
[5] Nagano Childrens Hosp, Life Sci Res Ctr, Azumino, Japan
[6] Matsumoto Dent Univ, Dept Pediat, Sch Dent, Shiojiri, Japan
基金
日本学术振兴会;
关键词
glucose infusion rate; hypoglycemia; parenteral nutrition; pediatric nutrition; stem cell transplantation; ENTERAL NUTRITION; GLUCOSE; DISCONTINUATION; HYPERGLYCEMIA; CHILDREN; TRIAL; RATES;
D O I
10.1177/0148607116665797
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Background: Parenteral nutrition (PN) is required with pediatric procedures such as hematopoietic stem cell transplantation (HSCT). However, risks associated with temporary PN infusion interruption remain unclear. Materials and Methods: We retrospectively analyzed in 22 children undergoing HSCT receiving PN with the same daily routine: temporary PN infusion interruption before breakfast for administering a saline-diluted acyclovir drip. After correcting patients' glucose levels, we examined minimum blood glucose levels between preparative regimen initiation and post-HSCT day 30. Patients were divided into 2 groups according to a minimum glucose cutoff of 60 mg/dL. Patient background characteristics and hypoglycemia risk factors were compared between both groups. Results: The hypoglycemia group had a significantly lower body surface area, higher glucose infusion rate (GIR), lower cholinesterase levels, and higher zinc levels at the onset of the minimum blood glucose level (P < .05). Multivariate analyses revealed an association only between higher GIR (5 mg/kg/min) and hypoglycemia during the temporary PN infusion interruption. A time course analysis of blood glucose and immunoreactive insulin (IRI) levels in 1 patient revealed a combined high-caloric and saline flush before acyclovir initiation, causing temporary increased IRI, as the etiology for hypoglycemia. Conclusions: Particular attention and several precautions are required to prevent complications associated with temporary PN infusion interruption in children with higher GIR.
引用
收藏
页码:1414 / 1418
页数:5
相关论文
共 13 条
  • [1] Enteral nutrition: a first option for nutritional support of children following allo-SCT?
    Azarnoush, S.
    Bruno, B.
    Beghin, L.
    Guimber, D.
    Nelken, B.
    Yakoub-Agha, I.
    Seguy, D.
    [J]. BONE MARROW TRANSPLANTATION, 2012, 47 (09) : 1191 - 1195
  • [2] Glucose response to discontinuation of parenteral nutrition in patients less than 3 years of age
    Bendorf, K
    Friesen, CA
    Roberts, CC
    [J]. JOURNAL OF PARENTERAL AND ENTERAL NUTRITION, 1996, 20 (02) : 120 - 122
  • [3] Management of Hyperglycemia During Enteral and Parenteral Nutrition Therapy
    Gosmanov, Aidar R.
    Umpierrez, Guillermo E.
    [J]. CURRENT DIABETES REPORTS, 2013, 13 (01) : 155 - 162
  • [4] Investigation of the freely available easy-to-use software 'EZR' for medical statistics
    Kanda, Y.
    [J]. BONE MARROW TRANSPLANTATION, 2013, 48 (03) : 452 - 458
  • [5] Association of hyperglycemia and markers of hepatic dysfunction with dextrose infusion rates in Korean patients receiving total parenteral nutrition
    Kim, H
    Son, E
    Kim, J
    Choi, K
    Kim, C
    Shin, W
    Suh, O
    [J]. AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY, 2003, 60 (17) : 1760 - 1766
  • [6] Koletzko Berthold, 2005, J Pediatr Gastroenterol Nutr, V41 Suppl 2, pS1, DOI 10.1097/01.mpg.0000181841.07090.f4
  • [7] Could enteral nutrition improve the outcome of patients with haematological malignancies undergoing allogeneic haematopoietic stem cell transplantation? A study protocol for a randomized controlled trial (the NEPHA study)
    Lemal, Richard
    Cabrespine, Aurelie
    Pereira, Bruno
    Combal, Cecile
    Ravinet, Aurelie
    Hermet, Eric
    Bay, Jacques-Olivier
    Bouteloup, Corinne
    [J]. TRIALS, 2015, 16
  • [8] Nirula R, 2000, AM SURGEON, V66, P866
  • [9] Enteral feeding and early outcomes of patients undergoing allogeneic stem cell transplantation following myeloablative conditioning
    Seguy, David
    Berthon, Celine
    Micol, Jean-Baptiste
    Darre, Stephane
    Dalle, Jean-Hugues
    Neuville, Sylvain
    Bauters, Francis
    Jouet, Jean-Pierre
    Yakoub-Agha, Ibrahim
    [J]. TRANSPLANTATION, 2006, 82 (06) : 835 - 839
  • [10] Metabolic Effects of Cyclic Parenteral Nutrition Infusion in Adults and Children
    Stout, Stephen Marc
    Cober, M. Petrea
    [J]. NUTRITION IN CLINICAL PRACTICE, 2010, 25 (03) : 277 - 281