Intravenous fluids and infusions

Publisher Summary This chapter discusses the types of intravenous fluids and infusions and their adverse effects. Priapism has been the subject of eight reports as a complication of total parenteral nutrition (TPN). Three different mechanisms have been postulated for this complication of TPN: (1) an increase in blood coagulability, (2) adverse effects on red blood cells, (3) and fat embolism. Lipids have an adverse effect on carbohydrate metabolism under basal conditions. In the study discussed in the chapter, the infusion of 20% of triglyceride emulsion with heparin during basal insulin and glucose turnover conditions resulted in a rise of plasma free-fatty acids from 0.4 to 0.8 mM with a low rate of infusion (0.5 mL/min for two hours) to between 1.6 and 2.1 mM with a high rate (1.5 mL/min for two hours). There were similar increases in plasma concentrations of glycerol, acetoacetate, and hydroxybutyrate. The infusions resulted in significant increases in C-peptide concentrations but had no effects on any of the other indices of carbohydrate metabolism that were examined (plasma glucose, lactate, and pyruvate concentrations) or on carbohydrate oxidation rates.