The use of exenatide in severely burned pediatric patients.
The use of exenatide in severely burned pediatric patients.
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DOI：
10.1186/cc9222
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发表时间：
2010
期刊：
影响因子：
--
通讯作者：
Jeschke MG
中科院分区：
文献类型：
--
作者：
Mecott GA;Herndon DN;Kulp GA;Brooks NC;Al-Mousawi AM;Kraft R;Rivero HG;Williams FN;Branski LK;Jeschke MG
强化胰岛素治疗（IIT）已被证明可以改善严重烧伤患者的烧伤后结局。然而，它增加了低血糖的发生率，并与风险和并发症有关。我们假设艾塞那肽会降低烧伤后的血糖水平，使其达到与IIT相似的水平，并减少外源性胰岛素的用量。这项开放标签研究纳入了24名严重烧伤的儿科患者。6人随机接受艾塞那肽，18人在急性住院期间接受IIT（区组随机化）。给予艾塞那肽和胰岛素以维持葡萄糖水平在80和140 mg/dl之间。我们测定了上午6点，每日平均，最高和最低葡萄糖水平。使用葡萄糖波动的平均幅度（法师）和变异系数的百分比确定变异性。比较两组胰岛素用量。两组的血糖值和变异性相似：干预组的每日平均值为130 ± 28 mg/dl，对照组为138 ± 25 mg/dl（P = 0.31），法师分别为41 ± 6和45 ± 12。然而，艾塞那肽组的胰岛素给药量显著低于IIT组：干预组为22 ± 14 IU患者/天，对照组为76 ± 11 IU患者/天（P = 0.01）。两组低血糖的发生率相似（0.38起事件/患者-月）。接受艾塞那肽治疗的患者接受的外源性胰岛素量明显较低，以控制血糖水平。艾塞那肽耐受性良好，可能是一种新型药物，以减轻高血糖症的重症监护环境。NCT 00673309。
Intensive insulin treatment (IIT) has been shown to improve outcomes post-burn in severely burnt patients. However, it increases the incidence of hypoglycemia and is associated with risks and complications. We hypothesized that exenatide would decrease plasma glucose levels post-burn to levels similar to those achieved with IIT, and reduce the amount of exogenous insulin administered. This open-label study included 24 severely burned pediatric patients. Six were randomized to receive exenatide, and 18 received IIT during acute hospitalization (block randomization). Exenatide and insulin were administered to maintain glucose levels between 80 and 140 mg/dl. We determined 6 AM, daily average, maximum and minimum glucose levels. Variability was determined using mean amplitude of glucose excursions (MAGE) and percentage of coefficient of variability. The amount of administered insulin was compared in both groups. Glucose values and variability were similar in both groups: Daily average was 130 ± 28 mg/dl in the intervention group and 138 ± 25 mg/dl in the control group (P = 0.31), MAGE 41 ± 6 vs. 45 ± 12 (respectively). However, administered insulin was significantly lower in the exenatide group than in the IIT group: 22 ± 14 IU patients/day in the intervention group and 76 ± 11 IU patients/day in the control group (P = 0.01). The incidence rate of hypoglycemia was similar in both groups (0.38 events/patient-month). Patients receiving exenatide received significantly lower amounts of exogenous insulin to control plasma glucose levels. Exenatide was well tolerated and potentially represents a novel agent to attenuate hyperglycemia in the critical care setting. NCT00673309.
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DOI：
10.1186/cc7755
发表时间：
2009
期刊：
Critical care (London, England)
影响因子：
--
作者：
Egi M;Bellomo R;Reade MC
通讯作者：
Reade MC
影响因子：
14.6
作者：
Griesdale, Donald E. G.;de Souza, Russell J.;Talmor, Daniel
通讯作者：
Talmor, Daniel
影响因子：
--
作者：
Linnebjerg, Helle;Park, Soomin;Horowitz, Michael
通讯作者：
Horowitz, Michael
DOI：
10.1073/pnas.4.12.370
发表时间：
1918-01-01
影响因子：
11.1
作者：
Harris, JA;Benedict, FG
通讯作者：
Benedict, FG
影响因子：
5.4
作者：
Rodbard, David
通讯作者：
Rodbard, David