Background & aims: To investigate the effects of glucose, parenteral amino acids, and intravenous insulin on albumin synthesis rates in critically ill children.
Methods: Two studies were performed in 8 post-surgical infants (age 9.8 ± 1.9 months; weight 9.5 ± 1.1 kg) and 9 septic adolescents (age 15 ± 1 yr; BMI 23 ± 4 kg m(-2)), respectively. All received a primed, constant, tracer infusion with [1-(13)C]Leucine. The infants in study 1 were randomized to receive low (2.5 mg kg(-1) min(-1)) and standard (5.0 mg kg(-1) min(-1)) glucose intake in a cross-over setting of two periods of 4 h each. The adolescents in study 2 were randomized to receive total parenteral nutrition with standard (1.5 g kg(-1) day(-1)) and high (3.0 g kg(-1) day(-1)) amino acid intake in a two day cross-over setting. On both study days, during the last 3 h of the tracer study, they received insulin infused at 80 mU m(-2) min(-1).
Results: The post-surgical infants and the septic adolescents were mildly hypoalbuminemic (∼2.5 g dL(-1)) with high synthesis rates, which were not affected by different intakes of glucose, amino acids, or insulin infusion.
Conclusions: Albumin synthesis rates in hypoalbuminemic critically ill children are high but were not upregulated through nutrient supply, and in septic adolescents are unaffected by insulin.
Copyright © 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.