EFFECTS OF INJECTION OF HYPERTONIC GLUCOSE ON METABOLISM OF WATER AND ELECTROLYTES IN PATIENTS WITH EDEMA 1

Abstract

600 to 1200 cc. of 25% glucose were admd. intraven. over 30-90 min. to 3 patients with cardiac edema, and 4 with edema caused by hepatic cirrhosis. Water was given by mouth to 4 subjects and withheld from 3. Urine flow was greatly augmented, but losses of water did not exceed the volume of fluid admd. Excretion of Na, K, P, and Cl usually rose temporarily, as massive glycosuria developed, and then fell. Diuresis of Na, however, was usually too small to produce appreciable reduction of increased stores of Na. Concns. of serum Na diminished sharply by as much as 20 meq./l. and subsequently returned toward control values. Serum K fell progressively, by as much as 2.2 meq./l. in 5 patients during initial expansion and despite later contraction of extracellular volume (chloride space). Aside from increased dyspnea in 1 patient, severe muscular cramps were the sole complication observed. These occurred exclusively in patients given glucose without supplementary intake of water and could not be definitely ascribed to changes in concn. of serum electrolytes or to the state of cellular hydration. Development of muscular spasms together with the trivial net losses of water and salt suggest that glucose, and probably similar loading substances as well, are of little value in the treatment of intractable edema.