[Comparative studies of administration of xylitol or glucose in parenteral infusion of amino acids in critical care patients].

Abstract

In a prospective, randomized study, two different concepts of carbohydrate application in the postoperative state were investigated and statistically analyzed in 20 intensive care patients in each group. Aim of the study was to evaluate influences of glucose or xylitol infusions in critically ill patients. Under the strict control of prerequisites for the application of parenteral nutrition in general and the application of specific substrates specifically, the study is based on the hypothesis that adverse reactions of the substrates like hyperglycemia should not occur. As a main result of the study, statistical significances of differences between the two groups could not be substantiated. The only difference between the two groups of severely ill patients with ventilation and hemodynamic support was an instability in glucose concentrations in blood under the application of glucose. Some patients in that group showed an increase in glucose concentration, which made insulin therapy necessary. We conclude that glucose is also applicable under the marked hormonally fixed conditions of postoperative metabolism if a narrow control of glucose is performed with an interruption of glucose application when concentrations increase. Also, on the basis of our data, xylitol showed a higher degree of security because under application of this substrate changes of glucose did not occur. In all cases where physiological conditions are achieved, glucose is the first choice of carbohydrates. In all those cases where the possibility exists that behind a normalized glucose concentration alterations of metabolism may be hidden, the application of xylitol offers the possibility to avoid imbalances and substrate load.(ABSTRACT TRUNCATED AT 250 WORDS)