Effect of withholding early parenteral nutrition in PICU on ketogenesis as potential mediator of its outcome benefit.

ABSTRACT:

Background

In critically ill children, omitting early use of parenteral nutrition (late-PN versus early-PN) reduced infections, accelerated weaning from mechanical ventilation, and shortened PICU stay. We hypothesized that fasting-induced ketogenesis mediates these benefits.

Methods

In a secondary analysis of the PEPaNIC RCT (N = 1440), the impact of late-PN versus early-PN on plasma 3-hydroxybutyrate (3HB), and on blood glucose, plasma insulin, and glucagon as key ketogenesis regulators, was determined for 96 matched patients staying ≥ 5 days in PICU, and the day of maximal 3HB-effect, if any, was identified. Subsequently, in the total study population, plasma 3HB and late-PN-affected ketogenesis regulators were measured on that average day of maximal 3HB effect. Multivaria

SUBMITTER: De Bruyn A 

PROVIDER: S-EPMC7456767 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature