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Hypophosphatemia during postoperative glucose infusion.

A Rasmussen

    Acta Chirurgica Scandinavica
    |January 1, 1985
    PubMed
    Summary

    Postoperative glucose infusions can cause a drop in inorganic phosphate levels, but hemodilution, solution tonicity, and infusion rate are not responsible. Expect a phosphate level decrease of 0.25-0.35 mmol/l with glucose administration.

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    Area of Science:

    • Biochemistry
    • Clinical Nutrition
    • Postoperative Care

    Background:

    • Postoperative intravenous fluid administration commonly includes glucose solutions.
    • A decrease in serum inorganic phosphate has been observed during such infusions.
    • The underlying mechanisms for this phosphate decrease require clarification.

    Purpose of the Study:

    • To investigate whether hemodilution contributes to the fall in serum inorganic phosphate during postoperative glucose infusion.
    • To determine if the tonicity of administered glucose solutions affects the magnitude of phosphate decrease.
    • To assess the impact of varying infusion rates on postoperative serum phosphate levels.

    Main Methods:

    • The study involved 48 patients divided into five subgroups.
    • Different tonicities (isotonic and hypertonic) of glucose solutions were administered.
    • Infusion rates were varied (0.30 g glucose/kg/hour and 0.15 g glucose/kg/hour).
    • Serum inorganic phosphate concentrations were monitored.

    Main Results:

    • Hemodilution was definitively excluded as a cause for the observed fall in serum phosphate.
    • The extent of the serum phosphate decrease was not influenced by the tonicity of the glucose solution.
    • Reducing the glucose infusion rate did not mitigate the fall in serum phosphate levels.

    Conclusions:

    • The fall in serum inorganic phosphate during postoperative glucose administration is an expected physiological response.
    • Hemodilution, solution tonicity, and infusion rate do not appear to be primary drivers of this phosphate decrease.
    • A consistent drop of approximately 0.25-0.35 mmol/l in serum phosphate should be anticipated when administering glucose postoperatively.

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