Carbohydrates – Guidelines on Parenteral Nutrition, Chapter 5Kohlenhydrate – Leitlinie Parenterale Ernährung, Kapitel 5

GMS German Medical Science — an Interdisciplinary Journal

K. Traeger⁴  J. Ockenga⁶  G. Kreymann⁵  K. W. Jauch²  H. Hauner³  C. Ebener⁷  U. Bolder¹ 

[1] Dept. of Surgery, University of Regensburg, Germany;Dept. of Surgery Grosshadern, University Hospital, Munich, Germany;ElseKroenerFresenius Centre for Nutritional Medicine, Technical University of Munich, Germany;Dept. of Anaesthesiology, University of Ulm, Germany;Dept. of Medicine, Univ. of Hamburg; currently Baxter S.A., Schaffhausenerstr., Zurich, Switzerland;Medical Clinic II, Hospital Bremen Centre, Germany;Dept. of General, Visceral and Children's Surgery, HeinrichHeineUniversity of Dusseldorf, Germany

关键词: insulin;    hyperglycaemia;    non-protein calories;    fructose;    glucose;   

Others  :  869107

实施日期：2009-01-14，发布日期：2009-11-18

【 摘 要 】

The main role of carbohydrates in the human body is to provide energy. Carbohydrates should always be infused with PN (parenteral nutrition) in combination with amino acids and lipid emulsions to improve nitrogen balance. Glucose should be provided as a standard carbohydrate for PN, whereas the use of xylite is not generally recommended. Fructose solutions should not be used for PN. Approximately 60% of non-protein energy should be supplied as glucose with an intake of 3.0–3.5 g/kg body weight/day (2.1–2.4 mg/kg body weight/min). In patients with a high risk of hyperglycaemia (critically ill, diabetes, sepsis, or steroid therapy) an lower initial carbohydrate infusion rate of 1–2 g/kg body weight/day is recommended to achieve normoglycaemia. One should aim at reaching a blood glucose level of 80–110 mg/dL, and at least a glucose level <145 mg/dL should be achieved to reduce morbidity and mortality. Hyperglycaemia may require addition of an insulin infusion or a reduction (2.0–3.0 g/kg body weight/day) or even a temporary interruption of glucose infusion. Close monitoring of blood glucose levels is highly important.

【 授权许可】

   
© 2009 Bolder et al.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

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