钠钾钙镁葡萄糖注射液用于骨科创伤患者手术的安全性

目的以乳酸钠林格注射液为对照,验证钠钾钙镁葡萄糖注射液用于骨科创伤患者手术的安全性。方法选下肢骨科创伤患者40例,ASA分级Ⅰ-Ⅱ级,随机分为试验组和对照组,试验组使用钠钾钙镁葡萄糖注射液,对照组使用乳酸钠林格注射液。两组均检测入室后输液前(T1)、输液后麻醉操作前(T2)、术毕(T3)、术毕后2 h(T4)患者血糖及电解质,并与入室前基础值(T0)比较,2组间比较.记录过敏及其他不良反应。结果在麻醉手术开始后,2组血糖水平都有升高,试验组和对照组血糖水平均随输注试验液体量的增加逐渐上升,T1、T2、T3与T0比较,差异有统计学意义(P﹤0.05),但均未超过15 mmol/L,在手术结束2 h后基本恢复至术前水平,2组间比较并差异无统计学意义(P>0.05)。2组间电解质浓度并无明显改变。结论钠钾钙镁葡萄糖注射液用于骨折创伤患者的疗效和安全性与乳酸钠林格注射液相当。与乳酸钠林格注射液相比,钠钾钙镁葡萄糖注射液并没有显著增加血糖水平。     

钠钾镁钙葡萄糖注射液应用于烧伤休克液体复苏的临床疗效评估——前瞻性、随机、单盲、阳性药物对照、多中心临床试验

目的 以乳酸钠林格注射液为对照,验证钠钾镁钙葡萄糖注射液(乐加(R))用于烧伤休克液体复苏方面的有效性和安全性.方法 198例符合入组标准的烧伤患者,伤后6h内开始实施液体复苏治疗,随机数字表法分为试验组和对照组,试验组使用钠钾镁钙葡萄糖注射液,对照组使用乳酸钠林格注射液.用法用量遵循1970年全国烧伤会议公式.液体复苏前测定受试者的血常规、肝肾功能、血生化、凝血功能指标,输液过程中监测血流动力学指标和动脉血气、血糖;在复苏开始后第1个24h、第2个24 h输液结束时同样测定受试者的血液实验室指标.有效性评价指标为受试者在输注上述两种含电解质液体前后的血清电解质、动脉血乳酸含量、血气指标、血糖变化情况,安全性评价指标为临床试验期间观察到的副作用的发生率和发生的具体情况.结果 通过血清电解质维持、血乳酸含量检测、血糖检测、酸碱平衡维持几个方面做出综合评价,两组比较差异无统计学意义.试验组中评为安全的受试者为99例,所占比例为100％.对照组中评为安全和大致安全的受试者为99例,所占比例为100％.两组在安全性分析方面比较差异无统计学意义.结论 在烧伤复苏中输注钠钾镁钙葡萄糖注射液,与目前临床中最常用的乳酸钠林格注射液有相同的安全性和有效性.     

术中输注醋酸钠钾镁钙葡萄糖注射液对酸碱平衡及电解质的影响

目的 比较术中输入复方氯化钠注射液、乳酸林格注射液、醋酸钠钾镁钙葡萄糖注射液对酸碱平衡及电解质的影响.方法 胃癌根治术患者48例,按随机数字表法分为复方氯化钠注射液组(N组)、乳酸林格注射液组(L组)、醋酸钠钾镁钙葡萄糖注射液组(A组),每组16例.N组术中输入复方氯化钠注射液,L组输入乳酸林格注射液,A组输入醋酸钠钾...     

钠钾镁钙葡萄糖注射液(乐加)用于手术中输液治疗的临床评估——前瞻性、随机、单盲、阳性药物对照、多中心临床试验

目的 以乳酸钠林格注射液为对照,验证钠钾镁钙葡萄糖注射液在手术中输注的有效性和安全性.方法 选择全身麻醉下行普外或骨科手术患者,ASA分级为Ⅰ～Ⅱ级,按随机数字表法分为试验组和对照组,试验组使用钠钾镁钙葡萄糖注射液,对照组使用乳酸钠林格注射液.以15 ml·kg-1·h-1的速度输注500 ml液体后行麻醉诱导,随后以10 ml·kg-1·h-1的速度维持前2 h,最后以8 ml·kg-1·h-1的速度维持至手术结束.术前测定受试者的血常规、肝肾功能、血生化、凝血功能指标,术中监测输液前即刻、诱导前即刻、诱导后1 h、2 h……输液结束时即刻各时间点的血流动力学指标和动脉血气、血糖;在手术结束时同样测定受试者的血液实验室指标.结果 通过循环动态维持、尿量维持、血糖控制、血清电解质维持、酸碱平衡维持5个方面做出综合评价,试验组有效率为100%,对照组有效率为99.53%,两组相比差异无统计学意义.试验组中评为安全和大致安全的受试者分别为200例和23例,所占比例分别为89.69%和10.31%.对照组中评为安全和大致安全的受试者分别为193例和18例,所占比例分别为91.47%和8.53%.两组在安全性分析方面相比差异无统计学意义.结论 在手术中输注钠钾镁钙葡萄糖注射液,与目前临床中最常用的乳酸钠林格注射液有相同的安全性和有效性.     

钠钾镁钙葡萄糖注射液术中输注对患者肝肾功能、血电解质、血糖、血乳酸及凝血功能的影响

目的 评估钠钾镁钙葡萄糖注射液（sodium potassium magnesium calcium and glucose,SPMCG）术中输注对患者肝肾功能、血电解质、血糖、血乳酸及凝血功能的影响.方法 择期拟在全身麻醉下行普外科或骨科手术的患者80例,美国麻醉医师协会（ASA）分级Ⅰ级～Ⅱ级,采用随机数字表法分为实验组和对照组,每组40例.实验组给予SPMCG,对照组给予乳酸钠林格注射液.两组均以15 ml·kg-1·h-1的速度输注500 ml液体后行麻醉诱导,诱导后以10 ml·kg 1·h-1的速度维持输液2h,之后以8 ml·kg-1h-1的速度维持至手术结束.输液前后测定患者的肝肾功能、血电解质以及凝血功能,并监测输液前即刻、诱导前即刻、诱导后1、2h和输液结束时即刻各时间点的血乳酸和血糖值.结果 两组患者输注相应液体后,丙氨酸氨基转移酶（alanine aminotransferase,ALT）、天门冬氨酸氨基转移酶（aspartateaminotransferase,AST）、白蛋白（albumin,ALB）、总胆红素（total bilirubin,TBIL）、血尿素氮（blood urea nitrogen,BUN）和血肌酐（serum creatinine,Cr）与输液前比较差异无统计学意义,组间比较差异无统计学意义.电解质方面,输液后2组Na＋、K＋、Cl-、Ca2＋的浓度差异无统计学意义,但实验组输液后Mg2浓度较对照组高[（0.48±0.21） mmol/L vs（0.71±0.31） mmol/L（P＜0.05）].手术过程中2组患者血糖均逐渐上升,术后又下降至输液前水平.两种液体输注后,凝血酶原时间（prothrombin time,PT）和部分凝血活酶时间（activated partial thromboplastin time,APTT）无显著变化.结论 在术中输注SPMCG,对患者肝肾功能、血电解质、血糖、血乳酸及凝血功能无明显不良影响,并且相对于乳酸钠林格注射液,SPMCG能更好地维持血镁水平.     

混合糖电解质注射液在择期便秘外科手术患者术后补液中的应用

目的探究混合糖电解质注射液在择期便秘外科手术患者术后应用是否能够稳定血糖、减轻乳酸堆积、补充血电解质。 方法筛选2013年11月至2014年1月有明确诊断的64例择期便秘外科手术患者,随机分为试验组（33例）和对照组（31例）,分别给予混合糖电解质注射液和10%葡萄糖电解质注射液。术后连续输注3 d,每天1 000 ml,不足部分按需补充。监测患者手术前和手术后3 d每次输液前后的血糖、乳酸水平及钙、镁、磷离子水平。 结果受试者均未出现相关不良反应或肝肾功能损害。两组患者手术后的血糖与手术前相比均有所升高,但在各时间点及各时间点与手术前的差值之间差异并无统计学意义,但对照组的血糖波动范围较大,试验组的血糖水平相对较为平稳。两组患者的血乳酸、血钙、血镁水平差异无统计学意义。自术后第2天起,试验组血磷水平明显高于对照组,术后第1天输液后至第3天输液前两组血磷水平均低于正常范围;而术后第3天输液后,试验组血磷水平恢复至正常范围,而对照组仍低于正常范围（P<0.05）。 结论择期便秘外科手术患者术后应用混合糖电解质注射液治疗既能对血糖水平有稳定作用,又能对血磷进行补充,是目前临床液体治疗的优先选择。     

血液回收技术中应用钠钾镁钙葡萄糖注射液对肝肾功能和血气指标的影响

目的评价钠钾镁钙葡萄糖注射液应用于血液回收技术中对患者肝肾功能和血气指标的影响。方法选择需行血液回收的神经外科手术患者60例,男31例,女29例,年龄19～67岁,BMI 21～25 kg/m~2,ASAⅠ或Ⅱ级。随机分为钠钾镁钙葡萄糖注射液组(N组)和生理盐水组(C组),每组30例。N组肝素冲管液采用低分子肝素钠25 000 IU加入钠钾镁钙葡萄糖注射液500 ml中配置,洗涤液全部应用钠钾镁钙葡萄糖注射液;C组肝素冲管液采用低分子肝素钠25 000 IU加入生理盐水500 ml中配置,洗涤液全部应用生理盐水。于血液回收前(T_0)、自体血输注完毕后(T_1)、手术后6 h(T_2)采集血样,检测ALT、AST、血清总胆红素(TBIL)、肌酐(Scr)、尿素氮(BUN)等肝肾功能指标;血氧饱和度50%时的氧分压(P_(50))、pH、血浆HCO_3~-、乳酸(Lac)、电解质(K~+、Na~+、Cl~-、Ca~(2+))、血糖(Glu)浓度等血气指标。结果与T_0时比较,T_1时C组BUN、Scr、Lac、Na~+、Cl~-、Glu浓度明显升高(P0.05),P_(50)明显升高(P0.05),pH和血浆HCO_3~-浓度以及K~+、Ca~(2+)浓度明显降低(P0.05)。与T_1时比较,T_2时C组BUN、Scr、Lac、Na~+、Cl~-、Glu浓度明显升高(P0.05),P_(50)明显升高(P0.05),pH和血浆HCO_3~-浓度以及K~+、Ca~(2+)浓度明显降低(P0.05)。与N组比较,T_1和T_2时C组BUN、Scr、Lac、Na~+、Cl~-、Glu浓度明显升高(P0.05),P_(50)明显升高(P0.05),pH和血浆HCO_3~-浓度以及K~+、Ca~(2+)浓度明显降低(P0.05)。两组不同时点AST、ALT、TBIL浓度差异无统计学意义。结论在血液回收中应用钠钾镁钙葡萄糖注射液配置肝素冲管液和洗涤液有利于减轻红细胞的损伤,改善红细胞携氧能力,维持内环境稳定和酸碱平衡,有利于保护患者肾功能,但对肝功能无明显影响。     

勃脉力A与复方乳酸钠临床应用的比较

比较手术中输注勃脉力A(复方电解质注射液 ,Plasma LyteA)与复方乳酸钠对人体血气、乳酸、电解质和酸碱平衡的影响。资料与方法一般资料　选择上腹部、骨科和乳腺等手术病人 ,ASAⅠ～Ⅱ级 ,无严重心肺和肝肾疾患 ,无电解质紊乱。年龄 18～ 6 5岁 ,体重 5 0～ 80kg ,随机分成复方乳酸钠组 (L组 )和勃脉力A组 (A组 ) ,每组 30例。术中施行全身麻醉。输注药物　分别输复方乳酸钠或勃脉力A (均为10 0 0ml塑袋装 ,百特医疗用品有限公司产品 ) ,术中按10 0 0ml/h输注 ,根据病人术中情况输注速度略有调整。观察指标　对输液前和输入 2 0 0 0ml…     

围术期输注6%羟乙基淀粉溶液和复方乳酸钠对血液动力学和酸碱平衡的影响

目的　比较围术期输入 6 %羟乙基淀粉 (HES)与复方乳酸钠对血液动力学和动脉血酸碱平衡的影响。方法　 4 0例择期手术患者 (ASAⅠ～Ⅱ级 ,2 0～ 4 0岁 ,男性 ) ,随机分为 6 %HES组 (H组 )和复方乳酸钠组 (R组 ) ,每组各 2 0例 ,所有患者采用蛛网膜下隙麻醉 ,30min内输入 6 %HES或复方乳酸钠 15ml/kg ,记录相应时间点SBP、DBP、HR、CVP、SV、CO ,并行动脉血气、酸碱平衡、电解质分析。结果　输液后 ,H组和R组CVP、SV和CO显著增高 ,且H组较R组升高更明显。pH、HCO 3 、BE于输液后 30min时轻度下降 (P <0 0 5 ) ,但R组在输入 6 0min后基本恢复正常 ,而H组一直持续至输液后 2 4 0min。R组Lac-在输入后明显升高 ,6 0min后逐渐下降。输注 6 %HES后血Cl-显著升高 (P<0 0 5 ) ,而输入复方乳酸钠后血Cl-无明显变化。输入 6 %HES后SID显著下降 ,30 0min后仍未恢复正常。输入复方乳酸钠后SID在 30～ 6 0min内下降明显 ,后逐渐恢复。输注液体 6 %HES或复方乳酸钠后Hct、Hb下降 ,且H组比R组明显 (P <0 0 5 )。结论　 6 %HES较复方乳酸钠扩容效果佳 ,但是输入 6 %HES可能导致轻度的代谢性酸中毒 ,应引起重视。     

急性扩容性血液稀释电解质的影响

目的对比观察乳酸钠林格液和万汶在术前急性扩容性血液稀释前后电解质的变化。方法20例病人随机分为万汶组(组1)和乳酸钠林格液组(组2)。病人入室开放静脉后分别给予两组液体15 ml/kg,30 min输注完毕。分别于输液前后抽血查血常规、电解质。结果两组扩容前后MAP、HR无明显变化,血K+稀释性降低。组1扩容后HCT下降明显,血Na+明显增加,但仍在正常范围之内。组2扩容后HCT明显下降,血Na+在正常范围之内。结论万汶扩容效果优于乳酸钠林格液,但可致血Na+升高,血K+稀释性降低。     

不同液体预输注对TUEVP患者循环及电解质的影响

目的比较复方乳酸钠、6%羟乙基淀粉130/0.4、4%琥珀酰明胶预输注对维持短时间经尿道前列腺汽化电切术(TUEVP)中循环及电解质变化的影响。方法择期行TUEVP(65min以内)的患者36例,随机均分为三组,分别于麻醉前30min内预输注复方乳酸钠(L组)、6%羟乙基淀粉130/0.4(H组)和4%琥珀酰明胶(S组)10ml/kg,术中三组均以生理盐水维持循环稳定。于麻醉前(T0)、膀胱灌洗液用量6000ml(T1)、12000ml(T2)、出室前(T3)记录MAP、HR、Na+、K+、血糖等变化。结果 L组总输液量(包括预输注液体量)多于H组和S组(P<0.05)。T2、T3时L组MAP明显降低(P<0.05),且T3时明显低于H组和S组(P<0.05)。L组Na+浓度随灌洗液量的增加呈下降趋势。结论复方乳酸钠麻醉前预输注用于短时程TUEVP手术与6%羟乙基淀粉130/0.4或4%琥珀酰明胶比较,手术的中后期MAP和血Na+浓度呈下降趋势。     

Lactated Ringer with 1% dextrose: an appropriate solution for peri-operative fluid therapy in children

Peri-operative blood glucose, total protein, and electrolytes values were measured in children (3–120 months) scheduled for minor surgery and randomly assigned to three groups according to the type of fluids administered during anaesthesia: children of RL group (n= 27) received lactated Ringer, those of RLD1 group (n= 25), 1% dextrose in lactated Ringer, and those in RLD2.5 group (n= 27), 2.5% dextrose in 0.4 N saline (50% D5, 50% RL) (63 mmol·l^-1). Infusion rate was set according to children's age and weight. Fluids were infused throughout the study with volumetric infusion pumps. Blood samples were obtained at induction (T0), at the end of surgery (T1), 30 and 60 min later (T2, T3). Pre-operative blood values were within the normal ranges except for high total protein values in all groups of children and for asymptomatic hypoglycaemia (2.3 and 2.5 mmol·l^-1) in two children. Blood glucose increased significantly in the three groups post-operatively (P < 0.001), and this increase was related to the amount of glucose infused. Glucose values differed significantly between groups at T1 and T2, while blood glucose values were back to the normal ranges at T2 and T3 in the RL group. Sodium values remained unchanged post-operatively in both RL and RLD1 groups, while a significant decrease was observed in the RLD2.5 group (P < 0.001). Total protein decreased in the three groups post-operatively (P < 0.001) towards normal values. These data suggest that RLD1 is appropriate for peri-operative fluid therapy in children. Its administration at the infusion rate used in this study, resulted in moderate post-operative hyperglycaemia while avoiding the risk of peri-operative hypoglycaemia, maintaining a constant extracellular fluid composition and correcting pre-operative fluid deficit.     

复方乳酸钠山梨醇注射液在大面积烧伤患者休克期补液中的应用

目的探讨复方乳酸钠山梨醇注射液(简称复钠醇)在大面积烧伤患者休克期补液中应用的可行性。方法将53例成年大面积烧伤休克期患者(均于伤后6h内入院)随机分为复钠醇组(24例)和葡萄糖组(29例)。复钠醇组在补液中用50g/L复钠醇作为基础水分,葡萄糖组用50g/L葡萄糖作为基础水分。剂量均为2000ml/d.两组患者复苏液中电解质和胶体量按相同公式计算后补给。同时,对葡萄糖组患者额外补充电解质及胰岛素。观察两组患者在纠正休克、能量提供及不良反应等方面的情况,监测肝、肾功能和电解质变化,记录休克期补液量及尿量,同时监测每例患者在入院时和伤后24、48、72h的血糖水平并作比较。结果两组患者在纠正休克、能量提供等方面无明显差别,复钠醇组患者未出现与复钠醇相关的不良反应及肝、肾功能损害,血糖水平均基本正常;在输液过程中,葡萄糖组需额外补充电解质及胰岛素才能维持稳定,而复钠醇组则不需要补充胰岛素或大量的电解质,且利尿效果优于葡萄糖组[复钠醇组伤后第1、2个24h平均尿量为(1.9±0.6)、(3.3±0.8)L,葡萄糖组为(1.0±0.5)、(2.3±0.8)L].结论大面积烧伤患者休克期应用复钠醇,可以有效补充血容量、纠正烧伤休克、利尿并促进水肿消退,同时既能补充电解质,又能提供部分能量,而且不影响血糖水平。     

Magnesium, calcium, sodium and potassium status in normotensive and hypertensive Johannesburg residents

Serum magnesium, calcium, sodium and potassium, and erythrocyte magnesium, sodium and potassium levels were measured in a selected group of 296 urbanised black male labourers in Johannesburg. Of these, 214 subjects were normotensive and 82 were hypertensive. The aim of the study was to examine the relationship between serum and erythrocyte electrolytes, specifically magnesium and calcium, and blood pressure in this population sample. The results showed a significant decrease in serum magnesium, calcium and potassium in the hypertensive subjects. Red blood cell magnesium was significantly lowered and red blood cell sodium was significantly raised in this group. A significant inverse correlation was found between serum magnesium and blood pressure, erythrocyte magnesium and blood pressure, serum calcium and blood pressure, and serum potassium and blood pressure. A positive correlation was observed between erythrocyte sodium and blood pressure. Of all the electrolytes assessed, magnesium (serum and erythrocyte) correlated most closely with blood pressure. The data reported here suggest that body magnesium and its interactions with calcium, sodium and potassium may, in certain groups of individuals, play an important role in the development and maintenance of high blood pressure.     

两种不同晶体液预扩容对剖宫产术后炎性反应的影响

目的探讨两种不同晶体液预扩容对剖宫产术产妇术后炎性反应的影响。方法选择择期剖宫产产妇60例,随机双盲分为复方乳酸钠组(RL组)和复方醋酸钠组(RA组),每组30例。麻醉前10 ml/kg晶体液预扩容,输液速率15~20 ml·kg-1·h-1。取左侧卧位行腰-硬联合麻醉。术中持续输入相应晶体液。分别在开始输液时(T1)、手术结束时(T2)、手术后4 h(T3)、24 h(T4)抽取静脉血,检测产妇血清中IL-6、TNF-α和CRP水平。结果 T1、T4时两组产妇CRP、IL-6和TNF-α水平差异无统计学意义。T2、T3时RA组CRP、IL-6和TNF-α水平明显高于RL组(P0.05)。结论复方醋酸钠导致产妇术后炎性因子释放的作用明显强于复方乳酸钠。     

Bicarbonate buffered ultrafiltration leads to a physiologic priming solution in pediatric cardiac surgery

Pediatric cardiopulmonary bypass (CPB) involves a high ratio of priming blood volume to patient blood volume. The composition of packed red blood cells (RBCs) is very unphysiological in terms of acid-base, electrolyte and metabolite values. Therefore, we tested the hypothesis whether ultrafiltration of the prime and replacement with bicarbonate buffered hemofiltration solution (BB-HS) is sufficient for reducing the metabolic load and reaching a physiologic state. For planned surgery of congenital heart defects with cardiopulmonary bypass, 20 CPB circuits were primed with BB-HS, gelatin and 1 unit of RBCs. The fluid was hemofiltrated using an ultrahemofilter at 300 ml/min until approximately 1000 ml of ultrafiltrate was restored with BB-HS. Blood gas analyses were obtained from the priming blood, once before and once after bicarbonate buffered ultrafiltration (BBUF). The measured substrates decreased significantly (P<0.001) after BBUF (glucose from 13.0+/-2.6 to 6.3+/-1.0 and lactate from 3.8+/-1.5 to 2.3+/-1.0 mmol/l). Acid-base parameters increased (P<0.001) to normal or high normal values (pH from 7.01+/-0.09 to 7.68+/-0.12; HCO(3) from 12.1+/-2.4 to 25.4+/-3.6 mmol/l and BE from -15.4+/-3.6 to -0.8+/-3.7 mmol/l). Even the electrolytes sodium, potassium and calcium changed significantly (P<0.001) toward the physiologic range. BBUF is an efficient method of reducing the metabolic load of priming. After BBUF, even the electrolyte and acid-base balance reached a physiologic state, which is important for minimizing electrolyte and acid-base disturbances after initiation of CPB.     

胃肠道手术新生儿围术期液体治疗对血糖的影响

目的 评价胃肠道手术新生儿围术期液体治疗对血糖的影响.方法 择期行胃肠道手术新生儿64例,ASA分级Ⅰ或Ⅱ级,随机分为4组(n=16),Ⅰ组麻醉前2 h口服清水,术中输注等张的醋酸林格氏液;Ⅱ组麻醉前2 h口服清水,术中输注2%葡萄糖生理盐水溶液;Ⅲ组麻醉前2 h口服10%葡萄糖液5 ml/kg,术中输注等张的醋酸林格氏液;Ⅳ组麻醉前2 h口服10%葡萄糖液5 ml/kg,术中输注2%葡萄糖生理盐水溶液.分别于麻醉诱导前补液开始即刻(T0)、麻醉诱导即刻(T1)、手术开始即刻(T2)、20 min(T3)、40 min(T4)、60 min(T5)、术后2 h(T6)时记录MAP和HR,同时取桡动脉血样测定血糖浓度,并于T0时测定乳酸浓度.结果 各组新生儿MAP和HR组内和组间比较差异无统计学意义(P＞0.05).与Ⅰ组比较,Ⅱ组和Ⅳ组T4-6时血糖浓度升高(P＜0.05),Ⅲ组各时点血糖浓度差异无统计学意义(P＞0.05);Ⅱ组和Ⅳ组各时点血糖浓度差异无统计学意义(P＞0.05).与Ⅰ组比较,Ⅲ组血乳酸浓度升高(P＜0.05);与Ⅱ组比较,Ⅳ组血乳酸浓度升高(P＜0.05).结论 胃肠道手术新生儿术前口服10%葡萄糖液,术中持续输注2%葡萄糖生理盐水溶液有利于维持围术期血糖的稳定.     

Comparison between glucose and a combination of glucose, fructose, and xylitol as carbohydrates for total parenteral nutrition of surgical intensive care patients.

The effects of four day periods of infusions of 600 gm/24 hours glucose and 600 gm/24 hours of a combination of glucose, fructose, and xylitol were compared. This study was performed during total parenteral nutrition of twelve postoperative patients with major complications. The mean plasma glucose level was significantly lower during the infusion of the combination of sugars (154.2+/-19.5 mg/100 ml versus 193.9+/-15.0 mg/100 ml[p is less than 0.005). Furthermore, the required dosage of exogenous insulin was significantly lower (18.9+/-12.3 units/day versus 43.7+/-19.7 units/day [p is less than 0.01). Mean renal carbohydrate losses were 0.85 per cent during glucose infusion and 1.7 per cent during infusion of the combination. The influence of both infusion regimes on values for pH, base excess, lactate, pyruvate, free fatty acids, insulin, sodium, potassium, chloride, magnesium, phosphorus, bilirubin, alkaline phosphatase, SGOT, and SGPT 0.85 has been investigated. No clinical side effects were observed. It is concluded that the administration of the investigated combination of glucose, fructose, and xylitol is justified in patients in whom hyperglycemia during infusion of glucose alone is difficult to control with insulin.