Utilization of a Glucose/Fructose/Xylitol Carbohydrate Solution During Surgery

Abstract

The utilization of a 4:2:1 mixture of glucose, fructose, and xylitol (GFX) was studied by indirect calorimetry in patients undergoing abdominal surgery. Sixteen patients undergoing gastrectomy under general anesthesia received GFX intravenously at 0.25 g/kg hr⁻¹ during surgery. ˙VO₂, ˙VCO₂ and RQ were measured continuously for 150 min using an Engström metabolic computer, and urea nitrogen excretion was determined at 30-min intervals during surgery. Blood levels of glucose, fructose, and xylitol plateaued after 1 h. The RQ decreased over the first 90 min from 0.84 ± 0.06 to 0.75 ± 0.05 and then gradually increased to 0.79 ± 0.04 at 150 min. ˙VO₂ did not change significantly over the 150-min period. From the RQ, ˙VO₂, and nitrogen excretion data, carbohydrate oxidation was estimated. The amount of carbohydrate oxidized was 9.7 ± 6.9 g during the first 30-min period, 3.5 ± 5.2 g during the 60 to 90-min period, and 7.5 ± 4.5 g in the 120 to 150-min study period. Simultaneously, lipid oxidation increased. These observations suggest that the GFX solution is adequately metabolized during surgery and therefore may be a suitable energy source for patients.

Key Words:

• Keywords Carbohydrate mixture (glucose
• fructose
• and xylitol)
• carbohydrate oxidation
• surgical patients