Infusion fluids contain harmful glucose degradation products

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

The ideal home hemodialysis machine

Daily home hemodialysis (HD) patients have a much superior survival rate than patients on regular, 3 times a week in-center HD or on peritoneal dialysis. Present-day HD machines are unsuitable for use at home by patients. We present our concept of the ideal home HD machine that allows daily short and long HD, does all the work preparing for and cleaning up after dialysis, has an intravenous infusion system controlled by the patient, needs no systemic anticoagulation, and teaches and interacts with the patient during dialysis. To fulfill these functionalities, the dialyzer and blood tubing must be integrated with the machine and replaced less often than monthly, the machine must be capable of at least 200 L/week of hemodiafiltration, prepare all fluids necessary between and during dialyses, and all the components and fluids must be much beyond ultrapure

Pitfalls in the interpretation of long-term inhalation experiments

Age- and weight-matched groups of mice were enclosed in airtight chambers and exposed to clean, filtered air for 1 month. At the end of the exposure period, body, liver and spleen weights and plasma butyrylcholinesterase (BuChE) activity were measured. More than twice as many significant differences in these parameters occurred compared with the expected results if only random differences existed between the groups. Thus, isolation of animal groups for extended periods of time in inhalation experiments alone may lead to differences in various biological parameters. When testing the effects of unknown substances such differences may be mistaken for reactions to the test agent, which actually may have no effect

Effects of Trichloroethylene inhalation on acid phosphatase in rodent brain

Rats, mice and gerbils were continuously exposed to 150 ppm trichloroethylene (TCE) for 30 days. In all three species, there was a marked increase in liver weight. In mice the weight increased more (86%) than in rats and gerbils (20%). After exposure the activity of acid phosphatase, a lysosomal marker enzyme, was tested in different brain areas, using a system which had a limit of detection of ± 10–15%. In most areas no significant influence was found. However, in the brain stem of mice and gerbils the phosphatase activity increased by approx. 10%