Plasma Volume Expansion Resulting from Intravenous Glucose Tolerance Test

Author:

Hahn Robert G.12,Nyström Thomas3

Affiliation:

1. Section for Anaesthesia, Faculty of Health Sciences, Linköping University, 58185 Linköping, Sweden

2. Research Unit, Södertälje Hospital, 152 86 Södertälje, Sweden

3. Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, 11883 Stockholm, Sweden

Abstract

Objective. To quantify the degree of plasma volume expansion that occurs during an intravenous glucose tolerance test (IVGTT).Methods. Twenty healthy volunteers (mean age, 28 years) underwent IVGTTs in which 0.3 g/kg of glucose 30% was injected as a bolus over 1 min. Twelve blood samples were collected over 75 min. The plasma glucose and blood hemoglobin concentrations were used to calculate the volume distribution (Vd) and the clearance (CL) of both the exogenous glucose and the injected fluid volume.Results. The IVGTT caused a virtually instant plasma volume expansion of 10%. The half-life of the glucose averaged 15 min and the plasma volume expansion 16 min. Correction of the fluid kinetic model for osmotic effects after injection reducedCLfor the infused volume by 85%, which illustrates the strength of osmosis in allocating fluid back to the intracellular fluid space. Simulations indicated that plasma volume expansion can be reduced to 60% by increasing the injection time from 1 to 5 min and reducing the glucose load from 0.3 to 0.2 g/kg.Conclusion. A regular IVGTT induced an acute plasma volume expansion that peaked at 10% despite the fact that only 50–80 mL of fluid were administered.

Funder

Stockholm County Council

Publisher

Hindawi Limited

Subject

Applied Mathematics,General Immunology and Microbiology,General Biochemistry, Genetics and Molecular Biology,Modeling and Simulation,General Medicine

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