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PubMedDate not supplied

Meeting the problems of first-generation insulin infusion pumps: clinical trial of a new miniature infuser.

We designed and constructed a new miniature, open-loop insulin infusion pump specifically to overcome the problems of many first generation insulin infusers. Special features are small size, adjustable volumetric basal infusion rate, rapid electronically mediated prandial insulin boosts, facility for doubling and halving the basal infusion rate and/or prandial delivery, and alarms for low battery state, motor over-run, stoppage, and control circuit malfunction. The infuser takes a specially designed syringe prefilled with short-acting insulin, sufficient in most diabetic patients for at least 7 days treatment with 100 U/ml insulin. To test clinical efficacy nine insulin-dependent diabetic patients received continuous subcutaneous insulin infusion (CSII) with the new infuser for periods up to 6 mo. Four patients previously CSII-treated with a first-generation pump and five who were new to CSII achieved and maintained the expected degree of near-normoglycemia. There were no pump breakdowns and a questionnaire completed by patients during the study confirmed ease and simplicity of operation and an appreciation of the advantages of the new pump compared with one widely used first-generation infuser.

Adult↗
PubMed1989

[Normoglycemic control by artificial pancreas in patients with pancreatic diabetes or with primary diabetes mellitus--analysis of patterns of insulin infusion and nocturnal glucose infusion].

It has been reported that patients with pancreatic diabetes (PD) show nocturnal hypoglycemia frequently when compared to patients with diabetes mellitus (DM). Present study was carried out to compare patterns of insulin infusion and nocturnal glucose infusion under normoglycemic control in between PD and DM. Eleven PD patients whose onset of diabetes mellitus appeared after the onset of chronic pancreatitis (PD group), and 10 patients with insulin-dependent diabetes mellitus without pancreatic disease (DM group) were studied. To control the blood glucose level, a closed loop insulin delivery system (Biostator GCIIS, Miles Laboratories) was used. 24 hours infused amount of insulin in PD group was not different from that in DM group, while patterns of insulin infusion in both groups were different. Thus, most of 24 h-infused insulin were given during 2 hours postprandial period in PD group, while in DM group, insulin was given mostly as a basal infusion. In this study glucose infusion occur in a state of hypoglycemia (less than 90 mg/dl). 7 of 11 in PD group and 2 of 10 in DM group had glucose infusion which mostly occurred at a night time.

Adolescent↗
PubMed1996

[Intrahepatic arterial infusion chemotherapy for the colon cancer patients with liver metastases--a comparison of arterial embolization chemotherapy versus continuous arterial infusion chemotherapy].

To compare the prognostic benefit between arterial embolization chemotherapy (AEC) and continuous arterial infusion chemotherapy (CAIC), we clinicopathologically examined 32 colorectal cancer patients with liver metastases. Seventy patients were treated with AEC, and 15 patients with CAIC. In the AEC regimen, either ADR or CDDP dissolved in Lipiodol was infused by the implanted reservoir every one to two months. Otherwise, for the CAIC regimen, 360 mg/m2/day of 5-FU was continuously infused by the reservoir for 14 days. Subsequently, on day 22 after the initial 5-FU infusion, 180 mg/m2/day of 5-FU was continuously infused for 7 days. After a 7-day interval without infusion, 180 mg/m2/day of 5-FU was infused for 7 days. This 7-day infusion/7-day no-infusion cycle was repeated. The efficacy of the AEC was 6% (1 PR + 7 NC + 9 PD), CAIC (6 PR + 4 NC + 5 PD), suggesting that CAIC provides the better response rate. With regard to prognosis, the 1- and 2-year survival rates of AEC were 63% and 19%, respectively. The median survival time was 415 days. Otherwise, the 1- and 2-year survival with CAIC was 54% and 40%, respectively, and the median survival time was 470 days. No significant difference between the AEC and the CAIC was observed in the colorectal cancer patients with liver metastases.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

Hemodynamic efficacy of rapid saline infusion and dobutamine versus saline infusion alone in a model of cardiac rupture.

Despite recent reports describing survival after cardiac rupture, the effectiveness of circulatory support while awaiting definitive surgical treatment is controversial. To assess the efficacy of volume expansion and pharmacologic support in cardiac tamponade due to cardiac rupture, a model of hemorrhagic cardiac tamponade was developed and treatment with rapid saline infusion and dobutamine was compared with rapid saline infusion alone in 15 closed chest dogs. A right ventricular wound of reproducible size was produced by deflating an aortic valvuloplasty balloon that had previously been passed by way of the internal jugular vein into the pericardial space and through a stab wound in the right ventricular free wall. Hemodynamic values were compared at baseline, during tamponade and after a rapid infusion (1 liter at 100 ml/min) of either saline solution alone or saline solution plus dobutamine (20 micrograms/kg per min). Atrial and pericardial pressures increased significantly in both groups. Mean arterial pressure, cardiac output and stroke volume increased with combined saline and dobutamine infusion to values similar to those at baseline (91 +/- 19%, 114 +/- 43% and 94 +/- 37% of baseline, respectively). In contrast, saline infusion alone caused a small increase in cardiac output but failed to significantly increase mean arterial pressure or stroke volume (76.8 +/- 14.2%, 55 +/- 18% and 51 +/- 17% of baseline, respectively). Combined rapid infusion of saline solution and dobutamine infusion has a more beneficial hemodynamic effect and may be more effective than rapid saline infusion alone in resuscitating patients with hemorrhagic cardiac tamponade due to cardiac rupture.

Animals↗
PubMed1987

Experimental comparison between hepatic artery infusion and occlusion-infusion of adriamycin.

Adult mongrel dogs were used to compare hepatic arterial infusion and arterial occlusion-infusion with regard to local and systemic Adriamycin levels. The drug was infused into the right proper hepatic artery of each dog after occlusion of the gastroduodenal artery. Blood and tissue samples were collected at regular intervals for Adriamycin determination. Four weeks later, each dog again received the same agent in the right proper hepatic artery, but this time arterial flow was blocked with an inflated balloon during drug infusion (arterial occlusion-infusion). Blood and tissue drug levels were determined and compared with those obtained using infusion without occlusion. Results indicate that when Adriamycin is administered into the hepatic artery of dogs, occlusion-infusion produces significantly greater hepatic venous drug levels, drug uptake, and drug metabolism than does infusion alone.

Animals↗
PubMed1976

Infusions of hFSH and hLH in normal men. II. Serum testosterone response to infused hLH and hFSH.

Standardized 4 h intravenous infusions of human follicle stimulating hormone (hFSH) and/or human luteinizing hormone (hLH) were given either separately or combined to 7 normal male volunteers. The infusions raised the serum gonadotrophin levels at least 10 (FSH) and 18 (LH) times above the basal ones. Serum testosterone (T) levels were measured serially before, during and after the infusions and, in 4 subjects, during a corresponding period of another normal day. During a normal or basal 24 h period fluctuations were seen and also a circadian rhythm with lower levels in the evening. The infusion of hFSH alone (3 subjects) did not alter the serum T levels. The infusion of hLH alone in 2 subjects raised serum T levels by 17% and 55% over those of the basal day. The combined FSH/LH infusion caused a significant rise (35-68%) in 4 subjects and greater rise in 2 of them than after infusion of the hLH alone. The serum T responses were gradual, reaching a maximum 7-8 h after the end of the infusion.

Adult↗
PubMed2000

Intravenous midazolam infusion for sedation of infants in the neonatal intensive care unit.

BACKGROUND: The need for sedation for neonates undergoing uncomfortable procedures in the neonatal intensive care unit (NICU) has often been overlooked. Proper sedation may reduce stress and avoid complications during procedures such as mechanical ventilation. Midazolam is a short acting benzodiazepine that has been increasingly used in the NICU. However, the effectiveness of intravenous midazolam as a sedative in neonates has not been systematically evaluated. OBJECTIVES: To determine whether intravenous midazolam infusion is an effective sedative, as evaluated by behavioural and/or physiologic measurements, for critically ill neonates undergoing intensive care, and to assess clinically significant short and long term adverse effects associated with its use. SEARCH STRATEGY: Literature search according to the Cochrane Neonatal Collaborative Review Group search strategy. Randomized and quasi-randomized controlled trials of intravenous midazolam use in neonates were identified by searching MEDLINE, EMBASE, the Cochrane Controlled Trials Register, reference lists of published studies, personal files, and abstracts published in Pediatric Research from 1990-1999. SELECTION CRITERIA: Randomized controlled trials of intravenous midazolam infusion in infants </= 28 days of age for sedation during mechanical ventilation or radiologic investigations were selected for review. Studies on midazolam use as an anesthetic or an anticonvulsant were excluded. Studies involving neonates and older infants and children were excluded if data for neonates could not be extracted. DATA COLLECTION AND ANALYSIS: Data regarding the primary outcome of level of sedation (as evaluated by behavioural scales or physiologic parameters) were abstracted. Secondary outcomes including intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), death within 28 days of age, adverse effects associated with midazolam (hemodynamic and neurologic), days of ventilation, days of supplemental oxygen use, pneumothorax, length of NICU stay, and long term neurodevelopmental outcome were assessed. When appropriate, meta-analyses were performed using relative risk (RR), risk difference (RD), along with their 95% confidence intervals (95% CI) for categorical variables and weighted mean difference (WMD) for continuous variables. MAIN RESULTS: Two trials were eligible for inclusion in the review. Data on level of sedation from the two trials could not be combined because of differences in tools used to measure sedation levels. One study (Jacqz-Aigrain 1994) showed statistically a significant higher level of sedation in the midazolam group compared to the placebo group. The other study (Anand 1999) comparing midazolam to morphine and placebo found no statistically significant difference in sedation level among the three groups, but statistically significantly higher level of sedation was found in the midazolam group compared with the placebo group during the treatment infusion. However, since the sedation scales used in both studies have not been validated in preterm infants, the effectiveness of midazolam as a sedative in this population could not be ascertained based on the findings of these two studies. In the study by Jacqz-Aigrain (1994), blood pressures were statistically significantly lower in the midazolam group than in the placebo group on days 1 and 2, although there was no statistically significant difference in the incidence of hypotension requiring albumin or vasoactive drugs between groups. The study by Anand (1999) showed a statistically significant higher incidence of adverse neurologic events (death, grade III-IV IVH, PVL) in the midazolam group compared with the other groups. In addition, the midazolam group had a statistically significantly longer duration of NICU stay compared to the placebo group (WMD 5.4 days, 95%CI 0.4, 10.5). (ABSTRACT TRUNCATED)

Humans↗
PubMed1989

Hepatic artery model for evaluating the distribution of intraarterial chemotherapy infusion: nonpulsed versus pulsed infusions.

The effect of a commercially available pulsatile slow-infusion system on the degree of infusate mixing and distribution was assessed in a life-size glass model of the hepatic arterial system. The authors determined, both visually and quantitatively, the mixing homogeneity of a low-flow infusion (1.4 mL/min) of red dye through a side-hole catheter (2.5 F outer diameter) into pulsatile flow (300 mL/min) of a fluid with the same viscosity as blood. When comparing nonpulsed versus pulsed infusion techniques, the authors found that the pulsatile infusion system did not significantly improve the inhomogeneity of dye distribution in the 16 hepatic arterial branches. The results of this in vitro study suggest that a pulsatile infusion system that uses low pulse velocities without regard for cardiac cycle is less than optimal and does not significantly improve drug mixing at the standard slow infusion rates. Moreover, as potential new intraarterial delivery systems are developed to improve drug mixing, in vitro models may be the most useful means of initially evaluating their efficacy.

Hepatic Artery↗
PubMed1994

Infusion methods for determination of peripheral resistance: influence of infused medium and back pressure.

It has been suggested that peripheral vascular resistance (PR), measured intraoperatively, can predict the outcome of infrainguinal reconstructions. There is, however, a great deal of variability in design and predictive value with this method, and it is prone to technical difficulties and possible errors. The present study evaluated the influence of the choice of infusion medium and the back pressure on PR as measured by the infusion technique. In a porcine model of experimentally induced stenosis, standard PR (calculated by the pressure difference across the stenosis and the Doppler volume flow) was compared with PR based on infusions of blood or saline solution. With blood as the infusion medium there was a significant correlation between the PR and the standard values (r = 0.795, p = 0.0005), whereas there was no correlation when saline solution was infused (r = 0.067, p = 0.345). Subtracting the back pressure resulted in a slight improvement in the correlations between standard PR and PR measured after infusion of blood but not saline solution. In summary, blood should be used as an infusion medium in methods of PR determination, but the influence of back pressure remains uncertain.

Animals↗
PubMed1998

[Causes of failure and dangers in the use of motor driven infusion pumps. Accidental closure of the infusion system].

UNLABELLED: Syringe drivers are used in anaesthetics, intensive care and emergency medicine to deliver small volumes of highly potent drugs with continuous, constant and reproducible flow. For early recognition of interruptions of the drug delivery caused by occlusion of the infusion system, an alarm is triggered as soon as the system pressure exceeds a certain limit. The sensitivity of this alarm depends on the flow rate, type-specific cut-off pressure and the elastic parameters of the infusion system. The sudden release of pressure built up in the system after occlusion occurred can cause delivery of an uncontrolled drug bolus and hence an additional hazard. METHODS: Six syringe drivers that are widely used in clinical practice were tested for alarm delay and bolus delivery in the event of an occlusion in the system. First, the alarm pressures at flow rates of 10, 50 and 100 ml/h were measured. Then the alarm delay time and bolus volumes post-occlusion were assessed, using a basic infusion system (syringe + single infusion set). Finally, several alterations to the system like extension, tap battery with germ filters or branching were made and their impact on alarm delay and bolus volume measured. RESULTS: Because of the great differences in alarm pressures between the devices tested, there were marked differences in the alarm delay at same flow rates. Predictably, there was an indirect proportional link between alarm delay and flow rate. Using the basic infusion system, alarm delays between 23 s and 143 min were measured. In two of the tested syringe drivers, a pressure-release mechanism is activated with the pressure alarm, which prevented bolus application. In the other devices, release of the pressure in the occluded system caused boli of 0.5-7 ml. Variations in the actual syringe volume and insertion of a second connection tube had no impact on alarm delay and bolus volume. Tap batteries, parallel running syringe drivers or trapped air in the system, however, caused marked increase in both alarm delay (107%) and bolus volume (+147%). DISCUSSION: Unidentified occlusions of the system cause grave malfunctioning of syringe drivers. While applying highly potent drugs, the discontinuation of drug delivery with subsequent bolus application can cause vital danger to the patient. As a result of the significant time delays in the pressure alarms, the devices tested do not provide sufficient protection against unrecognized system occlusion. Syringe drivers with adjustable alarm pressure can be set close to the actual infusion pressure. A further important point is that one should aim at a reduction in the elastic properties of the infusion set because of the great impact on alarm delay and bolus volume.

Equipment Failure↗
PubMed1991

Insulin absorption is faster when keeping the infusion site in use for three days during continuous subcutaneous insulin infusion.

To evaluate the possible influence of regular infusion site changes on insulin absorption, fifteen type 1 diabetic patients using continuous subcutaneous insulin infusion (CSII) were studied on four occasions: the first day after an infusion site was settled, again the first day after a new infusion site was utilized and the two fourth days after the two infusion sites had been used for three days. A bolus of insulin (1 U/10 kg of body weight) was infused by the pump in the lower para-umbilical region. Plasma free insulin and blood glucose levels were determined before and during 240 min of the study at 30-min intervals. It was found that the peak times extracted from the individual insulin curves were shorter in 17 out of 23 curves when the fourth day was compared with the first day and the mean value of peak time of the fourth day was significantly shorter than that of the first day (56 +/- 11 vs 110 +/- 15 min, P less than 0.01). The mean area under the insulin curves during the first hour of the study tended to increase on the fourth day compared to that of the first day (25 +/- 2.2 vs 21 +/- 2.1 mU.l-1.min, P = 0.12). The decremental area of blood glucose on the fourth day was larger than on the first day (405 +/- 111 vs 82 +/- 160 mmol.l-1.min, P less than 0.05). We conclude that during CSII, the absorption rate of the injected insulin bolus is faster when the infusion site has been in use continuously for three days.

Absorption↗
PubMed1993

Midazolam and fentanyl continuous infusion anesthesia for cardiac surgery: a comparison of computer-assisted versus manual infusion systems.

Continuous infusion of intravenous anesthetics can be achieved either by a manually controlled infusion (MCI) pump, or by a computer-assisted continuous infusion (CACI) pharmacokinetic model-driven infusion system. Randomized double-blind comparisons of the two infusion systems for general anesthesia were performed in 24 patients undergoing coronary artery bypass grafting. Patients were allocated to receive continuous infusions of midazolam and fentanyl by either a MCI device or CACI. Midazolam and fentanyl infusions were independently titrated to maintain hemodynamic stability, defined as mean arterial pressure (MAP) and heart rate (HR) within 20% of baseline values. As directed by the study design, comparable hemodynamic control was achieved in both groups. Mean plasma fentanyl concentrations measured at specific timepoints were similar between groups. The plasma midazolam level for induction was 196 +/- 139 ng/mL in the CACI group and 300 +/- 128 ng/mL in the MCI group, and the fentanyl level was similar in both groups, 6.7 +/- 1.9 ng/mL in CACI and 6.3 +/- 4.6 ng/mL in the MCI group. The drug levels were lower (P < or = .05) for midazolam during maintenance of anesthesia and similar for fentanyl during the maintenance of anesthesia. In the MCI group, the average duration of anesthesia was 246.5 +/- 35.0 minutes, with a mean total fentanyl dose of 30.27 +/- 11.14 micrograms/kg. In the CACI group, the average duration of anesthesia was 230.8 +/- 44.1 minutes, with a mean total fentanyl dose of 34.61 +/- 5.40 micrograms/kg (P > 0.05 for comparisons between groups for duration of anesthesia and total fentanyl dose).(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Intravenous↗
PubMed1993

Nursing implications of low-dose heparin to infusate to improve infusion site survival in children.

Initiation of intravenous (i.v.) infusions in hospital wards is a common surgical procedure. Unfortunately many of these infusions will fail due to phlebitis and/or extravasation. Such failure may cause considerable patient discomfort, interfere with i.v. therapy and increase the nurse's workload. I.v. problems with adults have been evaluated extensively, however little attention has been given to children. Heparin is effective in reducing thrombus formation and studies have demonstrated other properties as well, such as anti-inflammatory, anti-irritant, maintenance of endothelial integrity and homeostasis, and tissue healing. The purpose of this study was to determine if the addition of low-dose heparin to infusate would prolong infusion site survival in children. An experimental design was used whereby patients were randomly allocated into control and treatment groups. The treatment group received pre-mixed fluids containing 1 unit/ml of heparin whilst the control group received standard fluids. Data were collected using a standard form and information such as type and size of cannula, sex, age, date and time of cannulation, site, signs of phlebitis/extravasation, reasons for cannula removal and type of fluids and drugs infused, were recorded. Failure incidence was analysed by Cox's multivariate hazards model, life-table method and log rank tests. The results showed a highly significant difference (Chi 2 20.42, p < 0.0001) in decreasing infusion failure with the addition of low-dose heparin to infusate. Nursing implications could include a decrease in the incidence of extravasation and phlebitis, an increase in effective vein usage, fewer problems with i.v. flow rates, a reduction in medical/nursing hours associated with re-cannulations, less likelihood of systemic sepsis, and less patient worry and discomfort due to local venous reactions and re-cannulations.

Child↗
PubMedDate not supplied

Changes in circulating blood and plasma volume after hemoglobin-based oxygen carrier infusion and additional infusion of colloid solutions.

The aim of this study was to investigate the changes in circulating blood volume (CBV) after infusions of Hemoglobin glutamer-200 (bovine; Hb-200) in combination with 6% hetastarch in an animal model of acute posthemorrhagic anemia. Fifteen rabbits with a mean body weight of 2.2 +/- 0.2 kg were studied. After determination of the circulating plasma volume (CPV) and CBV, one third of the CBV was withdrawn via an arterial catheter. An equal volume of Hb-200 was then infused in the 5 animals in study group 1. In the remaining 10 animals, the same volume of 6% hetastarch solution was infused. Fifteen minutes after completion of the infusion, an additional infusion of 6% hetastarch at a dose equal to one third of the baseline CBV was performed in study group 1 and the control group. In study group 2, equal volumes of Hb-200 were infused. CPV measurements were performed at baseline, after hemorrhage, 5 and 15 minutes after volume replacement, and 1 and 15 minutes after hypervolemic hemodilution using the Evans blue dye dilution technique. The mean baseline CPV value was 53.4 +/- 1.1 mL/kg. The mean CBV at baseline was 90.8 +/- 4.9 mL/kg. After one third of the CBV was withdrawn, no differences in CBV or CPV were observed between the three groups. Replacement of one third of the CBV with Hb-200 significantly increased the CPV (73.7 +/- 1.8 mL/kg) when compared with the baseline level (53.5 +/- 1.8 mL/kg; n = 5; P < 0.05). The difference between the groups was first observed 15 minutes after infusion. CPV was significantly higher in study group 1 (87.0 +/- 2.2 mL/kg) compared with the other groups (80.2 +/- 2.6 mL/kg in the control group and 79.5 +/- 3.6 mL/kg in study group 2). After a second transfusion, the differences between the groups became more prominent. Study group 2 demonstrated the highest CPV and CBV. The two study groups demonstrated a statistically significant increase in circulating volumes compared with the control group. The magnitude of this difference was lower than expected based on in vitro colloid osmotic pressure measurements.

Anemia↗
PubMed2004

Accurate continuous drug delivery at low infusion rate with a novel microvolumetric infusion pump (MVIP): pump design, evaluation and comparison to the current standard.

Infusion devices for continuous and precise drug administration are indispensable tools in anaesthesia and critical care medicine. Problems such as start-up delays, non-continuous flow and susceptibility to hydrostatic pressure changes at low infusion rates resulting in accidental bolus release or prolonged flow interruption are inherent to current infusion technology. In order to improve precise drug delivery, an innovative technical concept has been realised in a novel microvolumetric infusion pump (MVIP) device. The MVIP principle includes repeated filling and emptying of a non-compliant microsyringe without the use of valves. The performance of the MVIP prototype has been evaluated and compared with standard syringe infusion pump assemblies. The novel MVIP concept has thereby proven to eliminate most problems during infusion start-up, steady state flow and vertical pump displacement, and has the potential of revolutionising infusion technology and setting a new dimension in patient safety.

Drug Administration Schedule↗
PubMed2006

Randomized, open-label, comparative study of piperacillin-tazobactam administered by continuous infusion versus intermittent infusion for treatment of hospitalized patients with complicated intra-abdominal infection.

The purpose of this randomized, multicenter, open-label study was to compare the continuous infusion of piperacillin-tazobactam with the standard intermittent infusion in 262 hospitalized patients with complicated intra-abdominal infections. Within 1 day of surgical intervention, eligible patients were randomized (1:1) to piperacillin-tazobactam 12 g/1.5 g administered continuously over 24 h or 3 g/0.375 g administered over 30 min intermittently every 6 h for 4 to 14 days. The demographics of the patients in the groups were similar, with a median APACHE II score of 7 and a median length of hospitalization of 7 days. Among 167 clinically evaluable patients, 86.4% and 88.4% of the patients treated with the continuous infusion and the intermittent infusion, respectively, were clinically cured or improved at the test-of-cure visit (P = 0.817). Bacteriological success was observed in 83.9% and 87.9% of patients (P = 0.597) in the two groups, respectively, and no differences in bacteriological response by pathogen were noted. Defervesence and white blood cell count normalization occurred in the majority of patients within 3 days and were similar between patients receiving the continuous infusion and those receiving the intermittent infusion. Drug-related adverse events were generally mild and were reported in similar numbers of patients in each arm of the trial. The results of this study support continuous infusion as a safe and reasonable alternate mode of administration of piperacillin-tazobactam for the treatment of complicated intra-abdominal infection.

APACHE↗
PubMed2002

Infusion of maintenance fluids with glucose (Veen 3G) is superior to maltose infusion (Actit) in the rate of energy utilization in rabbits.

In the present study, we examined the rates of urinary excretion of glucose and maltose after an infusion of maintenance fluid with glucose or maltose in adult rabbits. Three maintenance fluids (sugar-free, 5% glucose [Veen 3G] and 5% maltose [Actit]), which contained different sugars but were identical in electrolyte and acetate compositions and concentrations (Na: 45, K: 17, Mg: 5, Cl: 37, H2PO4: 10 and CH3COO: 20 mEq/l), were used in this study. In addition, the optimum infusion speed for maintenance therapy (10 ml/kg/h) was used. Animals were not given food or water during the 10-day period of administration. The body weights of the animals were measured every day. The concentrations of total protein, albumin, free fatty acids and glucose in the serum were measured. Urine samples for determination of glucose and maltose concentrations were collected from the 1st to 10th administrations. After infusion with 5% maltose, urinary maltose excretion decreased time-dependently, while that of glucose increased. This suggests that maltase activity time-dependently increases after infusion with maltose. In addition, total sugar was only minimally excreted into urine in the 5% glucose group compared with the 5% maltose group. Thus, the glucose infusion was superior to the maltose infusion in the rate of energy utilization. However, neither the loss of body weight nor the increase in concentration of free fatty acids in serum differed significantly among the 3 groups. In conclusion, infusion of maintenance fluid with 5% maltose results in the excretion of maltose and glucose into urine, since enzymatic hydrolysis of maltose to glucose is limited to that by maltase.

Analysis of Variance↗
PubMed1985

Evaluation of Talbot's safety zone of infusion volume and osmolality in infusion therapy for decompensated liver cirrhosis.

Problems with infusion therapy for correcting fluid and sodium imbalance in decompensated liver cirrhosis (DLC) were investigated by establishing the safety zone of Talbot et al. for parenteral fluid therapy in 4 DLC patients infused with over 900 ml of fluid each day for at least 9 days. The safety zone was different in each case. The safe infusion volume decreased and the safe electrolyte concentration shifted to a lower osmolality when there was ascites with renal failure than ascites without renal failure. Infusion therapy was performed without deterioration of the water and sodium balance in those patients whose infusion volume and fluid osmolality were in the safety zone. In contrast, ascites retention increased and peripheral edema appeared in patients whose infusion volume and osmolality were out of the safety zone. Therefore, the safety zone should be determined repeatedly during infusion therapy.

Aged↗