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Intraoperative protein sparing with glucose.

Thomas Schricker1, Ralph Lattermann, Franco Carli

  • 1Dept. of Anaesthesia, Mcgill University, Montreal, Quebec, Canada. thomas.schricker@mcgill.ca

Journal of Applied Physiology (Bethesda, Md. : 1985)
|August 17, 2005
PubMed
Summary

Intravenous glucose administration during colorectal surgery was found to reduce amino acid oxidation. This suggests that glucose infusion may help preserve protein during surgical stress.

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Area of Science:

  • Metabolism and nutrition
  • Surgical physiology

Background:

  • Amino acid oxidation increases during surgical stress.
  • The impact of intraoperative glucose infusion on amino acid metabolism is not fully understood.

Purpose of the Study:

  • To investigate whether intravenous glucose infusion inhibits amino acid oxidation during colorectal surgery.

Main Methods:

  • Randomized controlled trial with 14 patients undergoing colorectal surgery.
  • Patients received either intravenous glucose (2 mg x kg(-1) x min(-1)) or normal saline.
  • Stable isotope tracer technique (L-[1-(13)C]leucine) used to measure whole body leucine oxidation, rate of appearance, and nonoxidative disposal.
  • Blood samples analyzed for glucose, lactate, insulin, glucagon, and cortisol.

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Main Results:

  • Intraoperative leucine oxidation significantly decreased in the glucose group compared to the control group.
  • Leucine rate of appearance (protein breakdown) and nonoxidative leucine disposal (protein synthesis) decreased in both groups.
  • Glucose infusion led to hyperglycemia and increased insulin levels, lowering the glucagon/insulin quotient.
  • Cortisol levels increased in both groups, while lactate and glucagon remained unchanged.

Conclusions:

  • Intravenous glucose infusion at a rate of 2 mg x kg(-1) x min(-1) inhibits amino acid oxidation during colorectal surgery.
  • Glucose administration influences hormonal responses (insulin, glucagon) and may play a role in protein sparing during surgical stress.