Background Early treatment of severe hyperglycemia involves large shifts of body fluids that entail a risk of hemodynamic instability. We studied the feasibility of applying a new electrolyte equation that estimates the degree of volume depletion and the distribution of infused 0.9% saline in this setting. Methods The new equation was applied to plasma and urinary concentrations of sodium and chloride measured before and 30 min after a 30-min infusion of 1 L of 0.9% saline on two consecutive days in 14 patients with severe hyperglycemia (mean age 50 years). The extracellular fluid (ECF) volume was also estimated based on the volume dilution kinetics of chloride. Results On day 1, the baseline ECF volume amounted to 11.5 L. The saline infusion expanded the ECF space by 160 mL and the intracellular fluid space by 375 mL. On day 2, the ECF volume was 15.5 L, and twice as much of the infused fluid remained in the ECF space. The chloride dilution kinetics yielded baseline ECF volumes of 11.6 and 15.2 L on day 1 and day 2, respectively. No net uptake of glucose to the cells occurred during the two 1-h measurement periods despite insulin administration in the intervening time period. Conclusions The electrolyte equation was feasible to apply in a group of hyperglycemic patients. The ECF space was 3 L smaller than expected on admission but normal on the second day. Almost half of the infused fluid was distributed intracellularly.

中文翻译：

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重度高血糖患者输注 0.9% 生理盐水后基于电解质的液体变化计算

背景 严重高血糖症的早期治疗涉及体液的大量变化，这会带来血流动力学不稳定的风险。我们研究了应用新的电解质方程的可行性，该方程估计容量消耗的程度和在这种情况下注入的 0.9% 盐水的分布。方法 将新方程应用于 14 名严重高血糖患者（平均年龄 50 岁）连续两天输注 1 L 0.9% 生理盐水 30 分钟前和 30 分钟后的血浆和尿钠和氯浓度。细胞外液 (ECF) 体积也基于氯化物的体积稀释动力学估计。结果第1天，基线ECF体积达11.5 L。盐水输注使ECF空间扩大160 mL，细胞内液空间扩大375 mL。第 2 天，ECF 体积为 15.5 L，ECF 空间中保留了两倍的输注液体。氯化物稀释动力学在第 1 天和第 2 天产生的基线 ECF 体积分别为 11.6 和 15.2 L。尽管在中间时间段内施用了胰岛素，但在两个 1 小时测量期间未发生细胞对葡萄糖的净摄取。结论电解质方程适用于一组高血糖患者是可行的。入院时 E​​CF 空间比预期小 3 L，但第二天正常。几乎一半的输注液分布在细胞内。尽管在中间时间段内施用了胰岛素，但在两个 1 小时测量期间未发生细胞对葡萄糖的净摄取。结论电解质方程适用于一组高血糖患者是可行的。入院时 E​​CF 空间比预期小 3 L，但第二天正常。几乎一半的输注液分布在细胞内。尽管在中间时间段内施用了胰岛素，但在两个 1 小时测量期间未发生细胞对葡萄糖的净摄取。结论电解质方程适用于一组高血糖患者是可行的。入院时 E​​CF 空间比预期小 3 L，但第二天正常。几乎一半的输注液分布在细胞内。