[Carbohydrate infusions in internal diseases. A comparative study in metabolically healthy, liver diseased and diabetic patients. VIII. Continuous infusions of low dosage carbohydrate mixtures in patients with liver cirrhosis].

Basic caloric needs of patients with compensated liver cirrhosis and healthy controls were supplied for 48 h with mixtures of glucose, fructose, sorbite, and xylit. Mixed solutions (20% w/v) containing glucose + fructose (n = 6), glucose + sorbite (n = 36), glucose + xylit (n = 37) in a 1:1 ratio, and glucose + fructose + xylit (n = 6) in a 1:2:1 ratio as well as glucose alone (n = 6) were administered in a dosage of 0.25 g/kg/h each. Utilization of the monosubstances, corresponding blood levels, and the effects on parameters of carbohydrate and lipid metabolism were frequently controlled. In contrast to mixed solutions, infusion of glucose alone caused a pronounced increase of the insulin levels and hyperglycemia in some patients suffering from liver cirrhosis. In both groups infusion of glucose + xylit was accompanied by a rise of uric acid levels. In liver cirrhotics a permanent decrease of phosphate as well as an increase of xylit concentrations were observed. These changes were not seen with xylit lowered to 50%, in glucose + fructose + xylit infusion. Therefore, we recommend to restrict xylit in liver cirrhotics to 100/24 h. No significant changes of blood gas measurements, ph values, hyperlactatemia, or lactic acidosis were seen. There was no difference in the anticatabolic, antilipolytic, and antiketogenic effect of the solutions. The least changes of all controlled parameters were observed with glucose + fructose and glucose + fructose + xylit infusions.