No abstract

This experimental study was designed to investigate the efficacy of glucose loading during surgery. Rabbits, fasted overnight, received 20 ml·kg·h fluid infusion containing glucose at various concentration (0,0.5, 1.0, 1.5, 2.0% w/v) for 3 h intraoperatively. Plasma glucose level increased after the beginning of operation, but the increase was slight in groups given 0.2 g·kg·h or lower doses of glucose. Glucose at higher doses caused marked hyperglycemia. These higher doses also promoted urinary glucose excretion, and in the group given the maximum glucose dose (0.4 g·kg·h), this parameter was significantly elevated compared with findings in the 0.2 g·kg·h group (P<0.05), whereas it showed no significant difference among groups given 0-0.2g·kg·h. The liver glycogen content in animals that received no glucose was significantly lower than that of the 0.2 g·kg·h group (P <0.01). However, there was no correlation between glycogen level and glucose dose among groups receiving glucose. These results suggest that intraoperative glucose supplementation is effective in preventing glycogen depletion, and indicate that, to avoid glucose overloading, the optimal dose is 0.1-0.2 g·kg·h.

No abstract

SummaryIn order to investigate the optimal fat content for total parenteral nutrition (TPN) solutions, male Wistar rats were subjected to 70% hepatectomy and then placed, for five days, on one of five TPN regimens in which fat represented 0%, 10%, 20%, 30% and 40%, respectively, of the total calorie content. As serum triglyceride levels in the fat-treated groups were lower than those in the non-treated normal rats, it was concluded that the administered fat was sufficiently hydro lyzed. The greater the fat content, the higher the regeneration rate of the remnant liver. Significant differences were found between the 0%-fat group and 20%-plus fat groups. Hepatic triglyceride level was signifi cantly lower in the 20%-fat group. Hepatic protein level was significantly elevated in all fat-treated groups. Serum phospholipids and total choles terol due to the lecithin contained in fat emulsion were significantly elevated in the 30 and 40%-fat groups, indicating that fat content of 30 and 40% was excessive. The results suggest that TPN containing fat is superior to fat-free TPN for liver regeneration after partial hepatectomy, and that optimal fat content is estimated to be about 20% of total calorie content in the case of this fat emulsion.

These results suggest that the optimal dose for preoperative glucose infusion, in order to preserve carbohydrate or fat metabolism, is 0.1-0.2 or 0.3 g.kg(-1).h(-1), respectively, and indicate that administration should not be discontinued until the start of surgery.