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Infusion fluids contain harmful glucose degradation products.

Bryland, Anna LU ; Broman, Marcus; Erixon, Martin; Klarin, Bengt LU ; Lindén, Torbjörn; Friberg, Hans LU ; Wieslander, Anders; Kjellstrand, Per; Ronco, Claudio and Carlsson, Ola LU , et al. (2010) In Intensive Care Medicine May 4. p.1213-1220
Abstract
PURPOSE: Glucose degradation products (GDPs) are precursors of advanced glycation end products (AGEs) that cause cellular damage and inflammation. We examined the content of GDPs in commercially available glucose-containing infusion fluids and investigated whether GDPs are found in patients' blood. METHODS: The content of GDPs was examined in infusion fluids by high-performance liquid chromatography (HPLC) analysis. To investigate whether GDPs also are found in patients, we included 11 patients who received glucose fluids (standard group) during and after their surgery and 11 control patients receiving buffered saline (control group). Blood samples were analyzed for GDP content and carboxymethyllysine (CML), as a measure of AGE formation.... (More)
PURPOSE: Glucose degradation products (GDPs) are precursors of advanced glycation end products (AGEs) that cause cellular damage and inflammation. We examined the content of GDPs in commercially available glucose-containing infusion fluids and investigated whether GDPs are found in patients' blood. METHODS: The content of GDPs was examined in infusion fluids by high-performance liquid chromatography (HPLC) analysis. To investigate whether GDPs also are found in patients, we included 11 patients who received glucose fluids (standard group) during and after their surgery and 11 control patients receiving buffered saline (control group). Blood samples were analyzed for GDP content and carboxymethyllysine (CML), as a measure of AGE formation. The influence of heat-sterilized fluids on cell viability and cell function upon infection was investigated. RESULTS: All investigated fluids contained high concentrations of GDPs, such as 3-deoxyglucosone (3-DG). Serum concentration of 3-DG increased rapidly by a factor of eight in patients receiving standard therapy. Serum CML levels increased significantly and showed linear correlation with the amount of infused 3-DG. There was no increase in serum 3-DG or CML concentrations in the control group. The concentration of GDPs in most of the tested fluids damaged neutrophils, reducing their cytokine secretion, and inhibited microbial killing. CONCLUSIONS: These findings indicate that normal standard fluid therapy involves unwanted infusion of GDPs. Reduction of the content of GDPs in commonly used infusion fluids may improve cell function, and possibly also organ function, in intensive-care patients. (Less)
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published
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Intensive Care Medicine
volume
May 4
pages
1213 - 1220
publisher
Springer
external identifiers
  • wos:000278523400015
  • pmid:20397009
  • scopus:77954383995
ISSN
0342-4642
DOI
10.1007/s00134-010-1873-x
language
English
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yes
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7b320dbd-eb5e-4db2-9894-d679ab5d1a55 (old id 1595185)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20397009?dopt=Abstract
date added to LUP
2010-05-04 21:58:19
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2018-05-29 10:50:08
@article{7b320dbd-eb5e-4db2-9894-d679ab5d1a55,
  abstract     = {PURPOSE: Glucose degradation products (GDPs) are precursors of advanced glycation end products (AGEs) that cause cellular damage and inflammation. We examined the content of GDPs in commercially available glucose-containing infusion fluids and investigated whether GDPs are found in patients' blood. METHODS: The content of GDPs was examined in infusion fluids by high-performance liquid chromatography (HPLC) analysis. To investigate whether GDPs also are found in patients, we included 11 patients who received glucose fluids (standard group) during and after their surgery and 11 control patients receiving buffered saline (control group). Blood samples were analyzed for GDP content and carboxymethyllysine (CML), as a measure of AGE formation. The influence of heat-sterilized fluids on cell viability and cell function upon infection was investigated. RESULTS: All investigated fluids contained high concentrations of GDPs, such as 3-deoxyglucosone (3-DG). Serum concentration of 3-DG increased rapidly by a factor of eight in patients receiving standard therapy. Serum CML levels increased significantly and showed linear correlation with the amount of infused 3-DG. There was no increase in serum 3-DG or CML concentrations in the control group. The concentration of GDPs in most of the tested fluids damaged neutrophils, reducing their cytokine secretion, and inhibited microbial killing. CONCLUSIONS: These findings indicate that normal standard fluid therapy involves unwanted infusion of GDPs. Reduction of the content of GDPs in commonly used infusion fluids may improve cell function, and possibly also organ function, in intensive-care patients.},
  author       = {Bryland, Anna and Broman, Marcus and Erixon, Martin and Klarin, Bengt and Lindén, Torbjörn and Friberg, Hans and Wieslander, Anders and Kjellstrand, Per and Ronco, Claudio and Carlsson, Ola and Godaly, Gabriela},
  issn         = {0342-4642},
  language     = {eng},
  pages        = {1213--1220},
  publisher    = {Springer},
  series       = {Intensive Care Medicine},
  title        = {Infusion fluids contain harmful glucose degradation products.},
  url          = {http://dx.doi.org/10.1007/s00134-010-1873-x},
  volume       = {May 4},
  year         = {2010},
}