title: Assessment of xylitol serum levels during the course of parenteral nutrition including xylitol in intensive care patients: a case control study.
abstract: OBJECTIVE
  Xylitol has been approved for parenteral nutrition and may be beneficial in catabolic situations. The aim was to establish an easy method to monitor xylitol serum levels in patients receiving xylitol and to determine whether xylitol is safe.
  
  
  METHODS
  A commercially available xylitol test was validated and used to measure serum levels in 55 patients admitted to our intensive care unit with an indication for parenteral nutrition with xylitol for at least 24 h. Controls consisted of the most recent 56 patients admitted to the intensive care unit who received parenteral nutrition without xylitol for at least 2 days. Xylitol serum levels were determined using the test. Adverse events, liver enzymes, lactate, bilirubin, γ-glutamyl transpeptidase, and insulin requirement were secondary endpoints.
  
  
  RESULTS
  Patients receiving xylitol received 32.6% less insulin than controls. The amount of energy they received was comparable (xylitol: 810.1; controls: 789.8 kcal). Mean liver enzymes and lactate levels were similar in both groups. Adverse events considered attributable to xylitol did not occur. Xylitol did not accumulate in patients' blood and returned to near baseline values one day after parenteral nutrition was stopped.
  
  
  CONCLUSIONS
  Parenteral nutrition with xylitol appears to be safe for critical care patients. There were no signs of hepatoxicity.
  DRKS00004238.
authors.affiliation: Department of Gastroenterology, Hepatology, and Endocrinology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany. Electronic address: andrea.s.schneider@gmx.de.
authors.forename: Andrea S
authors.initials: AS
authors.lastname: Schneider
authors.affiliation: Department of Gastroenterology, Hepatology, and Endocrinology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany.
authors.forename: Anika
authors.initials: A
authors.lastname: Schettler
authors.affiliation: Department of Gastroenterology, Hepatology, and Endocrinology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Markowski
authors.affiliation: Department of Gastroenterology, Hepatology, and Endocrinology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany.
authors.forename: Birgit
authors.initials: B
authors.lastname: Luettig
authors.affiliation: Department of Gastroenterology, Hepatology, and Endocrinology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Momma
authors.affiliation: Department of Gastroenterology, Hepatology, and Endocrinology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Seipt
authors.affiliation: Department of Gastroenterology, Hepatology, and Endocrinology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Hadem
authors.affiliation: Department of Gastroenterology, Hepatology, and Endocrinology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany.
authors.forename: Michaela
authors.initials: M
authors.lastname: Wilhelmi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001663:Bilirubin / Q000097:blood; D016022:Case-Control Studies; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007362:Intensive Care Units; D019344:Lactic Acid / Q000097:blood; D008099:Liver / Q000187:drug effects / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition / Q000379:methods*; D015203:Reproducibility of Results; D014993:Xylitol / Q000008:administration & dosage* / Q000097:blood*; D055815:Young Adult; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D007328:Insulin; D019344:Lactic Acid; D005723:gamma-Glutamyltransferase; D001663:Bilirubin; D014993:Xylitol
keywords: Antioxidants; Critically ill; Early feeding; Nutrient; Parenteral nutrition; Sepsis