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Title: Effect of increasing intravenous glucose load in the presence of normoglycemia on outcome and metabolism in critically ill rabbits
Authors: Derde, Sarah ×
Vanhorebeek, Ilse
Ververs, Eric-Jan
Darras, Veerle
Van Herck, Erik
Van den Berghe, Greet #
Issue Date: Mar-2009
Conference: International Symposium on Intensive Care and Emergency Medicine edition:29 location:Brussels date:24-27 March 2009
Article number: P119
Abstract: Introduction:
Endocrine disturbances during critical illness lead to a feeding-resistant wasting-syndrome, characterised by
profound protein breakdown, promoting delayed recovery and poor outcome. Parenteral nutrition failed to
counteract the hypercatabolic state, possibly due to aggravation of the detrimental hyperglycemic response to
critical illness. In our rabbit model of prolonged critical illness we investigated the impact of varying intravenous
glucose load, while maintaining normoglycemia, on mortality, organ damage, and catabolism/anabolism.
Methods:
Critically ill rabbits were randomised into a fasting group, a standard parenteral nutrition group, and two groups
receiving either an intermediate or high additional amount of intravenous glucose within the physiological range,
all maintained normoglycemic with insulin. These normoglycemic groups were compared with a hyperglycemic
group (similar high glucose load as the last normoglycemic group) and with healthy rabbits. Protein and lipid
load was equal for all fed groups.
Results:
Varying intravenous glucose load did not affect mortality or organ damage, provided normoglycemia was
maintained. Fasted critically ill rabbits lost weight, which was attenuated by increasing intravenous glucose load.
As compared to healthy rabbits, mRNA expression of several components of the ubiquitin-proteasome-pathway
was elevated in skeletal muscle of fasted critically ill rabbits, which was counteracted by intravenous feeding.
Except in the normoglycemic group with intermediate glucose load, circulating IGF-1 and thyroid hormone levels
decreased in all groups, most pronounced in hyperglycemic rabbits.
Conclusions:
Provided normoglycemia is maintained, increasing intravenous glucose within the physiological range is safe for
organ function and survival of critically ill rabbits and reduces catabolism compared to fasting.
Publication status: published
KU Leuven publication type: IMa
Appears in Collections:Laboratory for Intensive Care Medicine (-)
Animal Physiology and Neurobiology Section - miscellaneous
Clinical and Experimental Endocrinology
Laboratory of Intensive Care Medicine
× corresponding author
# (joint) last author

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