[Carbohydrate and lipid metabolism following heart bypass operations. The effect of the intravenous hypocaloric administration of glucose versus glucose xylitol (1:1)].
The effect of glucose-xylitol infusion on carbohydrate and lipid metabolism was investigated in 18 metabolically normal men (mean age 56.1 [35-65] years) with coronary heart disease after they had undergone a coronary artery bypass operation. During the first postoperative hours, group I (n = 6) received glucose only (2 mg/kg.min), group II (n = 6) glucose+xylitol (1 mg/kg.min each), and group II a glucose-containing electrolyte solution (0.83 mg/kg.min glucose). Blood glucose and insulin concentrations during the infusion period were significantly (P < 0.05) lower in groups II and III than I (glucose after 6 h: group I 21.5 [15.3-26.8] mmol/l; group II 14.2 [11.2-18.1] mmol/l; group III 12.6 [6.8-16.0] mmol/l). The highest lactate concentrations were reached in group I, 6 hours after the operation. Palmitine and stearine, as well as oleic and linoleic acid concentrations were significantly lower 12 hours postoperatively in group I than groups II and III (P < 0.05). These data indicate that energy-ineffective high glucose concentrations were avoided and endogenous lactate production reduced by the postoperative infusion of glucose+xylitol. In addition, it achieved a higher supply of free fatty acids as energy source to the myocardium without reaching toxic concentrations in the postischaemic myocardium.
Gross
G
G
Chirurgische Klinik mit Poliklinik, Universität Erlangen, Nürnberg.
Schricker
T
T
Hilpert
W
W
Braun
G
G
von der Emde
J
J
Georgieff
M
M
D000328:Adult; D000368:Aged; D002241:Carbohydrates / Q000097:blood*; D002315:Cardiopulmonary Bypass; D002149:Energy Intake; D005947:Glucose / Q000008:administration & dosage*; D006801:Humans; D007262:Infusions, Intravenous; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D013997:Time Factors; D014993:Xylitol / Q000008:administration & dosage*
D002241:Carbohydrates; D008055:Lipids; D005947:Glucose; D014993:Xylitol
Kohlenhydrat- und Fettstoffwechsel nach Herz-Bypass-Operationen. Einfluss intravenöser hypokalorischer Zufuhr von Glucose versus Glucose-Xylit (1:1).