Sepsis Clinical Trial
Official title:
Gluconeogenesis Rates and Its Source in Critically Ill Adolescents
Critically ill children have abnormal utilization of nutrients such as glucose, lipids and protein. Often sick children have increased glucose concentrations in blood. However, the origin of the high glucose has not been determined in these populations. There is a close interrelationship between protein and energy metabolism. An increase in the energy supply will not promote nitrogen retention unless the amino acid supply is adequate, and conversely, an increased amino acid supply will be useless if energy is limiting, hence the importance of adequate protein and energy intake. Our study aims to investigate the protein-energy interactions in critically ill septic children and adolescents with the objective to eventually provide the best nutritional support for these patients.
This is an observational study, aimed at exploring:
i) gluconeogenesis rates ii) sources of gluconeogenesis and pyruvate cycling, and iii)
protein kinetics in critically ill children and adolescents, and its differences by age
group, as well as in comparison to healthy adolescents. The study size will include 45
critically ill septic, pediatric patients (22 children at 5-12 years of age and 23
adolescents' at 13-19 years of age), male and females admitted to the pediatric intensive
care unit (PICU) at Children's Medical Center, Dallas. The minimal subject's weight will be
17kg. Additionally, 30 healthy adolescents matched by age, gender, BMI and Tanner stage will
be studied at the Clinical Translational Research Center at Zale Lipshy Hospital, to serve
as healthy adolescent controls. The number of subjects includes an expected drop out rate of
about 20%, in order to obtain 18 patients with complete data in each group. Patients will
receive nutritional support as per standard care. This study will yield important knowledge
and may lead in the future to changes in the current practice on the management of
critically ill pediatric patients in the PICU.
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Observational Model: Cohort, Time Perspective: Prospective
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