Volume kinetics of glucose solutions given by intravenous infusion

Glucose solutions given by intravenous (i.v.) infusion exert volume effects that are governed by the amount of fluid administered and also by the metabolism of the glucose. To understand better how the body handles glucose solutions, two volume kinetic models were developed in which consideration was given to the osmotic fluid shifts that accompany the metabolism of glucose. These models were fitted to data obtained when 21 volunteers who were given approximately 1 litre of glucose 2.5 or 5% or Ringer’s solution (control) over 45 min. The maximum haemodilution was similar for all three fluids, but it decreased more rapidly when glucose had been infused. The volume of distribution for the infused glucose molecules was larger (∼12 litres) than for the infused fluid, which amounted to (mean (sem)) 3.7 (0.3) (glucose 2.5%), 2.8 (0.2) (glucose 5%), and 2.5 (0.2) litres (Ringer). Fluid accumulated in a remote (cellular) body fluid space when glucose had been administered (∼0.2 and 0.4 litres, respectively), while expansion of an intermediate fluid space (7.1 (1.3) litres) could be demonstrated in 33% of the Ringer experiments. In conclusion, kinetic models were developed which consider the relationship between the glucose metabolism and the disposition of intravenous fluid. One of them, in which infused fluid expands two instead of three body fluid spaces, was successfully fitted to data on blood glucose and blood haemoglobin obtained during infusions of 2.5 and 5% glucose. Br J Anaesth 2001; 87: 834–43