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45. Intraoperative infusion of acetated Ringer solution containing glucose and ionized magnesium reduces ketogenesis and maintains serum magnesium.

Author

Yokoyama, Takeshi, Suwa, Kunio, Yamasaki, Fumiyasu, Yokoyama, Reiko, Yamashita, Koichi, and Selldén, Eva

Subjects
*INFUSION therapy, *BLOOD sugar, *SURGERY, *METABOLISM, *PHYSIOLOGIC salines, *KETONES
Abstract

The effect of glucose infusion during surgery on glucose metabolism has not been investigated sufficiently. We, therefore, examined the effect after the infusion of 1% glucose acetated Ringer solution containing Mg2+ during surgery on ketogenesis and serum Mg2+ concentrations. Patients, classified as ASA I-II, age 51-80 years, were randomly assigned to receive infusion of acetated Ringer solution. The G/Mg group received infusion with 1% glucose, Na+ 140mEq/L, Mg2+ 2 mEq/L, and the C group received infusion with glucose free solution containing Na+ 130 mEq/L without Mg2+. Both solutions were infused at a rate of 25 mL/kg for the first hour, and maintained at 4 mL/kg/hr thereafter. Blood samples were collected three times: before infusion and at 1 hour and 4 hours after the start of infusion. Electrolytes and glucose metabolism were evaluated at each sampling. After rapid infusion, blood glucose level significantly increased to 170±19mg/dL in the G/Mg group, but it returned to close to baseline after 4 hours and serum ketone bodies did not increase during infusion. In the C group, however, blood glucose never increased beyond 110 mg/dL, but both acetoacetic and hydroxybutyric acids increased significantly at the third measurement. [ABSTRACT FROM AUTHOR]

Published
2008

47. Ischemia may be less detrimental than anemia for O2 transport because of CO2 transport: A model analysis

Author

Suwa, Kunio

Abstract

Abstract: We analyzed the relationship between oxygen delivery (Do2) and Pto2 (tissue Po2). We found an important factor which has not been specified before. In the previous O2 transport model, Do2 was a dependent variable, calculated from hemoglobin, blood flow, Pao2, and the oxygen dissociation curve (ODC). In this study, the model was modified slightly so that the Do2 can be an independent variable. We allowed, instead, one of the three parameters, hemoglobin, blood flow, and Pao2 to be a dependent variable. We compared the brain tissue Po2 under three conditions, hypoxemia, ischemia and anemia, at the same Do2. To further elucidate the mechanism produced by the effect of CO2 transport on the ODC, we studied the effect of the Bohr factor (d log Po2/d pH) and of the gas exchange ratio (Vco2/Vo2) on the O2 transport. Ischemia maintains a slightly higher tissue Po2 than anemia at the same Do2 level. In ischemia the CO2 transport is disturbed, leading a higher draining venous Pco2, which in turn maintains a higher Po2 the capillary, resulting in a higher gradient for Po2 between capillary and the tissue. Between ischemia and anemia, ischemia is less detrimental than anemia. In ischemia, the CO2 transport is disturbed, which in turn maintains a higher Po2 at the capillary.

Published
1995
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