To evaluate the protoscolicidal effects of various concentrations of hypertonic glucose, live protoscolices of sheep were exposed to 10%, 15%, 25% and 50% glucose solutions. Cetrimide (0.5%), silver nitrate (0.5%) and hypertonic saline (20%) were used as positive controls, while physiological saline was used as a negative control. After 1, 2 and 5 min, the protoscolicidal effects were determined by 1% eosin. A 25% glucose solution had no significant protoscolicidal effect. However, a 50% glucose solution revealed higher protoscolicidal effect than 0.5% silver nitrate but weaker effect than 0.5% cetrimide; the effect was comparable with that of 20% hypertonic saline. The results showed that hypertonic glucose solution is highly effective in killing protoscolices of Echinococcus granulosus in vitro.
Sheep Diseases/*parasitology ; Sheep ; Glucose Solution, Hypertonic/*pharmacology ; Echinococcus granulosus/*drug effects/isolation & purification ; Echinococcosis/*parasitology ; Animals

OBJECTIVETo study the resuscitative effect of hypertonic electrolyte glucose solution (HEGS) in enteral resuscitation of burn shock.

METHODSEighteen Beagle dogs with 35% TBSA full-thickness flame injury were used in this study. They were randomized to a control group (no-fluid resuscitation, N group), a HEGS resuscitation group (H group) or an isotonic electrolyte glucose solution (IEGS) resuscitation group (I group). The solution enterally was given for resuscitation from half an hour after burn. The volumes and rates of fluid infusion in the H group were basically in accordance with 2 ml/(kg x 1%TBSA), those in the I group were basically in accordance with parkland formula [4 ml/(kg x 1%TBSA)]. The haemodynamic parameters, global end-diastolic volume index, plasma volume, osmotic pressure of plasma, intestinal absorptive rates of water and Na(+), and intestine mucosa blood flow were continuously assessed.

RESULTSThe cardiac output index, global end-diastolic volume index, plasma volume and intestine blood mucosa flow reduced markedly after burn in the three groups, and then gradually returned from 2 h after burn in two resuscitation groups, which were higher than that in the N group (P < 0.05). The activities of diamine oxidase in plasma in the two resuscitation groups were higher than that in N group (P < 0.05). The intestinal absorption rates of water and Na(+) reduced markedly after burn in two resuscitation groups with the lowest levels, and then returned from 6 h after burn. The rates of water in H group were lower than that in I group (P < 0.05); the rates of Na(+) in H group were higher than in I group (P < 0.05).

CONCLUSIONThe results indicated that 35%TBSA III degrees burn-injury dogs be resuscitated effectively with 1.8% hypertonic electrolyte-glucose solution by enteral, which 1/2 volume of an isotonic electrolyte glucose solution.

Animals ; Burns ; therapy ; Disease Models, Animal ; Dogs ; Enteral Nutrition ; Fluid Therapy ; methods ; Glucose Solution, Hypertonic ; administration & dosage ; therapeutic use ; Random Allocation ; Resuscitation ; methods ; Saline Solution, Hypertonic ; administration & dosage ; therapeutic use

OBJECTIVES: The main purpose of this study was to quantify the risk of mortality linked to various regimens of hypertonic peritoneal dialysis (PD) solution. METHODS: A retrospective cohort study of patients using home-based PD was carried out. The prescribed regimen of glucose-based PD solution for all patients, determined on the basis of their individual conditions, was extracted from their medical chart records. The primary outcome was death. The treatment regimens were categorized into 3 groups according to the type of PD solution used: original PD (1.5% glucose), shuffle PD (1.5 and 2.5% glucose), and serialized PD (2.5 and 4.5% glucose). Multivariate analysis (using the Weibull model) was applied to comprehensively examine survival probabilities related to the explanatory variable, while adjusting for other potential confounders. RESULTS: Of 300 consecutive patients, 38% died over a median follow-up time of 30 months (interquartile range: 15-46 months). Multivariate analysis showed that a treatment regimen with continued higher-strength PD solution (serialized PD) resulted in a lower survival rate than when the conventional strength solution was used (adjusted hazard ratio, 2.6; 95% confidence interval, 1.6 to 4.6, p < 0.01). Five interrelated risk factors (age, length of time on PD, hemoglobin levels, albumin levels, and oliguria) were significant predictors contributing to the outcome. CONCLUSIONS: Frequent exposure to high levels of glucose PD solution significantly contributed to a 2-fold higher rate of death, especially when hypertonic glucose was prescribed continuously.
Cohort Studies* ; Follow-Up Studies ; Glucose ; Glucose Solution, Hypertonic* ; Humans ; Kidney Diseases ; Mortality* ; Multivariate Analysis ; Peritoneal Dialysis* ; Retrospective Studies* ; Risk Factors ; Survival Rate ; Thailand

BACKGROUND: The present work was designed to examine the altered expression of peritoneal AQP-1 and water transport of peritoneal membrane during the long-term peritoneal dialysis with hypertonic glucose solution in rats. METHODS: Eighteen Sprague-Dawley male rats were randomly divided into 2 groups: control rats (n=6) with peritoneal catheter but not dialyzed; rats with peritoneal dialysis (PD) (n=12) were dialyzed with 4.25% glucose dialysate for all exchanges. Before completion of the study, 4 animals in PD group were euthanized owing to nonfunctional catheters or peritonitis, leaving 14 animals for the analysis. Dialysis exchanges were performed 3 times a day with 25 mL/each exchange for 12 weeks. Immunoperoxidase staining was performed using monoclonal anti-AGE antibody and polyclonal anti-AQP-1 antibody. The slides were read by 5 different examiners in a blind fashion. The staining intensity was graded semiquantitively from 0 to 3. The peritoneal membrane function was assessed by performing one-hour peritoneal equilibration tests every 6 week for comparing transport characteristics. Peritoneal membrane transport rate was assessed by D/P of urea nitrogen and D/Do of glucose. Water transport of peritoneal membrane was assessed by D/P of sodium at 12 week. RESULTS: The expression of peritoneal AQP-1 was increased in rats with PD, compared to control rats. Consistent with this, D/P of sodium in rats with PD was significantly decreased compared to control rats (0.58+/-0.04 vs 0.86+/-0.07, p<0.05), indicating high peritoneal water permeability in response to long-term peritoneal dialysis. Moreover, rats with PD were associated with significantly lower D/Do of glucose and higher D/P of urea nitrogen, suggesting high peritoneal membrane transport. CONCLUSION: High expression of peritoneal AQP-1 was associated with an increased peritoneal water permeability in response to long-term peritoneal dialysis with 4.25% glucose for 12 weeks. The underlying mechanisms for the increased AQP-1 expression need to be examined whether it is due to the continuous exposure to the dialysis solution containing high glucose concentration itself or compensatory effects of slowly developed concomitant ultrafiltration failure in chronic peritoneal dialysis.
Animals ; Catheters ; Dialysis ; Glucose ; Glucose Solution, Hypertonic ; Humans ; Male ; Membranes ; Nitrogen ; Peritoneal Dialysis* ; Peritonitis ; Permeability ; Rats* ; Rats, Sprague-Dawley ; Sodium ; Ultrafiltration ; Urea ; Water*

Adolescent ; Adult ; Aged ; Endoscopy ; Epistaxis ; therapy ; Female ; Glucose Solution, Hypertonic ; administration & dosage ; therapeutic use ; Hemostatic Techniques ; Humans ; Male ; Middle Aged ; Nasal Mucosa ; Young Adult

OBJECTIVETo study the change in intestinal barrier and organ functions of burned dog after enteral administration of hypertonic electrolyte glucose solution (HEGS) in shock stage.

METHODSTwenty-four Beagle dogs inflicted with 35% TBSA full-thickness burn were divided into no-fluid group (NF), intravenous infusion with isotonic electrolyte glucose solution (IEGS) group (II group), enteral infusion with IEGS group (EI), and enteral infusion with HEGS group (EH) according to the random number table, with 6 dogs in each group. Saline, containing 50 g/L glucose, was intravenously or enterally infused into dogs in II group and EI group respectively 0.5 hour post injury (PIH) for resuscitation. Total infusion volume within PIH 24 was 4 mL x kg(-1) x %TBSA(-1) (half of the total volume was infused in the first 8 hours in a constant speed, the other half volume was infused in the rest 16 hours in a constant speed). HEGS, containing 18 g/L NaCl and 50 g/L glucose, was enterally infused into dogs in EH group. Total infusion volume within PIH 24 was 2 mL x kg(-1) x %TBSA(-1), with the same infusion speed as that in II and EI groups. Liver and kidney function indexes [activity of ALT and CK-MB, expression levels of creatinine and blood urea nitrogen (BUN) in serum], activity of diamine oxidase (DAO), and activity of Na(+)-K(+)-ATPase in intestinal mucosa at PIH 24 were determined.

RESULTSALT activity in each group was close to one another. Serum levels of creatinine and BUN in II, EI, and EH groups were significantly lower than those in NF group. CK-MB activity obviously increased at PIH 2 in every group. CK-MB activity in EH group at PIH 2 to 8 was respectively lower than that in NF and II groups. DAO activity in serum in II, EI, and EH groups decreased since PIH 4 or PIH 6, respectively from (3.9 + or - 0.6) U/L to (3.6 + or - 0.5) U/L, (4.8 + or - 0.4) U/L to (2.8 + or - 0.8) U/L, (6.4 + or - 1.8) U/L to (3.5 + or - 0.8) U/L, all were significantly lower than those in NF group [from (12.5 + or - 0.4) U/L to (9.7 + or - 1.1) U/L, comparison between EH group and NF group, t value at PIH 4, 6, 8, 24 was respectively 10.25, 12.44, 17.99, 16.21, P values all below 0.05]. The order of Na(+)-k(+)-ATPase activity in intestinal mucosa at PIH 24 in each group from high to low was II group, EH group, EI group, and NF group (comparison between former 3 groups and NF group, t value was respectively 10.09, 4.96, 8.32, F value was 26.79, P values all below 0.05).

CONCLUSIONSHEGS does not cause significant harm to the barrier function of intestinal mucosa of shock dog after burn. Compared with NF, HEGS can significantly improve functions of heart, liver, and kidney, and it can achieve the same resuscitation effect as enteral or intravenous infusion of IEGS with only half of the solution volume.

Animals ; Burns ; drug therapy ; metabolism ; physiopathology ; Disease Models, Animal ; Dogs ; Fluid Therapy ; Glucose Solution, Hypertonic ; administration & dosage ; therapeutic use ; Heart ; physiopathology ; Intestinal Mucosa ; metabolism ; Intestine, Small ; physiopathology ; Kidney ; physiopathology ; Liver ; physiopathology

Peritoneal dialysis has been widely considered to be the dialytic treatment of choice for acute renal failure in infants and young children, because the technique is simple, safe and easily adapted for these patients. Also peritoneal dialysis in infants might have more effective ultrafiltration and clearance than in adults. In certain circumstances associated with hemodynamic instability, ordinary volume peritoneal dialysis (30-50 ml/kg body weight per exchange) or hemodialysis may not be suitable unfortunately. But frequent cycled, low volume, high concentration peritoneal dialysis may be more available to manage the acute renal failure of newborns and infants. Seven infants underwent peritoneal dialysis for hemodynamically unstable acute renal failure with low exchange volume (14.2±4.2 ml/kg), short exchange time (30 to 45 minutes) and hypertonic glucose solution (4.25% dextrose). Age was 1.9±1.3 months and body weight was 4.6±1.6 kg. Etiology of acute renal failure was secondary to sepsis with or without shock (5 cases) and postcardiac operation (2 cases). Catheter was inserted percutaneously with pigtail catheter or Tenkhoff catheter by Seldinger method. Dialysate was commercially obtained Peritosol which contained sodium, chloride, potassium, magnesium, lactate and calcium. Net ultrafiltration (ml/min) showed no difference between low volume dialysis and control (0.27±0.09 versus 0.29±0.09). Blood BUN decreased from 95.7±37.5 to 75.7±25.9 mg/dl and blood pH increased from 7.122±0.048 to 7.326±0.063 after 24 hours of peritoneal dialysis. We experienced hyperglycemia which were controlled by insulin (2 episodes), leakage at the exit site (2), mild hyponatremia (1) and Escherichia coli peritonitis (1). Two children of low volume dialysis died despite the treatment. In our experience, low volume and high concentration peritoneal dialysis with frequent exchange may have sufficient ultrafiltration and clearance without significant complications in the certain risked acute renal failure of infants.
Acute Kidney Injury ; Adult ; Body Weight ; Calcium ; Catheters ; Child ; Dialysis ; Escherichia coli ; Glucose Solution, Hypertonic ; Hemodynamics ; Humans ; Hydrogen-Ion Concentration ; Hyperglycemia ; Hyponatremia ; Infant* ; Infant, Newborn* ; Insulin ; Lactic Acid ; Magnesium ; Methods ; Peritoneal Dialysis* ; Peritonitis ; Potassium Chloride ; Renal Dialysis ; Sepsis ; Shock ; Sodium ; Ultrafiltration