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Journal of Parenteral and Enteral Nutrition
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Original Communications

Glucose in Parenteral Nutrition: A Survey of US Medical Centers

Paul R. Schloerb, MD

From the Department of Surgery, University of Kansas Medical Center, Kansas City, Kansas

Correspondence: Paul R. Schloerb, MD, Department of Surgery, Mail Stop 3019 University of Kansas Medical Center, Kansas City, KS 66160. Electronic mail may be sent to pschloer{at}kumc.edu.

Background: A previous report suggested that glucose administration in total parenteral nutrition (TPN) should not exceed 4 mg/kg/min with a respiratory quotient (RQ) >1.0. This rate would not be exceeded, in most patients, with a TPN glucose concentration of 15%. Our previous survey of hospitals, 7 years ago, of TPN composition revealed use of excessive glucose. Our purpose was to reevaluate glucose usage in TPN. Methods: A subset of data from 45 hospitals participating in Novation's Medication Use Evaluation program, "Parenteral Nutrition for Adults and Neonates" study, was analyzed to document glucose administration in TPN. Results: Data of 629 adult patients from 44 hospitals receiving TPN were analyzed. Of these, 30 hospitals with 478 patients had 100 patients (15.9% of the total) with TPN glucose infusion rates >4 mg/kg/min, whereas 27 hospitals, or 61%, had average TPN glucose concentrations above 15%. This could be associated with an RQ >1.0, implying increased net lipogenesis. Conclusions: The majority of hospitals surveyed were found, as in a previous survey, to be using amounts of glucose in TPN which would be expected to be associated with an RQ >1.0, implying increased net lipogenesis.

Journal of Parenteral and Enteral Nutrition, Vol. 28, No. 6, 447-452 (2004)
DOI: 10.1177/0148607104028006447
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