[Metabolic behavior and utilization of parenterally administered carbohydrates in the postoperative phase]

Abstract

60 patients who had to undergo the same operation were subdivided at random into five groups. Each group obtained in respect to the part of carbohydrates a different infusion solution (5% glucose, 5% fructose, 5% xylitol, 5% xylitol-glucose-fructose, 5% sorbitol) with an always constant part of electrolytes, the dosage of which was 60 ml/kg body weight on the day of operation and 40 ml/kg body weight during the first 3 postoperative days being continuously distributed over 24 hours. From the day before the operation until the third postoperative day the effects on metabolic parameters (lactate, uric acid, blood glucose and others) as well as the utilization of the different energy carriers were investigated. While after a glucose infusion, due to a reduced utilization, no change of the lactate level could be proved in the postoperative phase, the effect of fructose on the lactate concentration was most evident. The administration of xylitol was followed by a small increase of the serum uric acid on the first and second postoperative day, whereas in the other groups its decrease could be proved - there was no change after the administration of sorbitol. The highest blood glucose levels were found in the group to which glucose and the three-part solution of xylitol-glucose-fructose were administered. About the utilization of the different energy carriers only a limited information could be given. Altogether the results allow the conclusion that a combination of xylitol, glucose, and fructose or alternatively sorbitol can be considered the most favourable carbohydrates for preparing an isotonic base electrolyte solution.