Hypoglycemia caused by lipid emulsion (10%)/amino acids(15) and glucose (20%) injection: report of 2 cases

Two male patients(patient 1, 64 years old; patient 2, 63 years old)received parenteral nutrition in fasting state due to the future surgical operation for gastric space-occupying lesions and gastrointestinal bleeding, respectively. Both of them developed fatigue and cold sweat near the end of the first IV infusion of the lipid emulsion (10%)/amino acids (15) and glucose (20%) injection. Their instant blood glucose levels were 2.2 mmol/L and 2.1 mmol/L, respectively. The symptoms disappeared about 10 minutes after the immediate discontinuation of the injection and an intravenous injection of 50% glucose injection 40 ml. And their instant blood glucose levels were 5.6 mmol/L and 5.4 mmol/L, respectively. Patient 2 developed the above symptoms again near the end of the second infusion of the drug next day and his instant blood glucose level was 2.6 mmol/L. His symptoms disappeared again after the drug withdrawal and treatment of an intravenous injection of 50% glucose 40 ml and an IV infusion of 10% glucose 250 ml for about 15 minutes. Then his instant blood glucose level was 5.9 mmol/L. Key words: Parenteral nutrition; Fat emulsions, intravenous; Amino acids; Glucose; Hypoglycemia