Maximal Parenteral Glucose Oxidation in Hypermetabolic Young Children: A Stable Isotope Study

Background: During periods in which nutrition support of critically ill young children must be parenteral, glucose infusions are administered at up to 10 or more mg · kg-1 · min-1 to meet predicted energy needs. However, data in adults suggest that such high glucose loads exceed the ability to oxidize glucose in the hormonal milieu that characterizes critical illness. The purpose of this study was to determine if these high glucose loads are oxidized by critically ill young children. Methods: Ten young children with serious burns were enrolled in a stable isotope study of glucose metabolism. These five boys and five girls were an average age of 5.2 years (range, 1 to 11 years), weight of 18.4 kg (range, 10 to 31 kg) and burn size of 51.6% of the body surface (range, 35% to 86%). During clinically required episodes of parenteral nutrition support, we used the [13C6]glucose tracer to assess the efficacy of glucose oxidation at both 5 and 8 mg · kg-1 · min-1. Serum glucose was recorded and indirect calorimet...