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Estimation of the initial distribution volume of glucose by an incremental plasma glucose level at 3 min after i.v. glucose in humans
Author(s) -
Hirota Kazuyoshi,
Ishihara Hironori,
Tsubo Toshihito,
Matsuki Akitomo
Publication year - 1999
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1046/j.1365-2125.1999.00889.x
Subject(s) - volume of distribution , extracellular fluid , bolus (digestion) , plasma glucose , interstitial fluid , volume (thermodynamics) , plasma clearance , intravenous bolus , mathematics , medicine , chemistry , urology , nuclear medicine , endocrinology , diabetes mellitus , pharmacokinetics , extracellular , biochemistry , physics , thermodynamics
Aims The initial distribution volume of glucose (IDVG) could be a clinically useful indicator of the central extracellular fluid (ECF) space volume, namely the interstitial fluid volume status of highly perfused organs. In this study, we determined the formula of IDVG using incremental plasma glucose levels after i.v. glucose. Methods One hundred and fifty patients admitted to the general intensive care unit of the University of Hirosaki hospital were entered into this prospective study which was conducted in two stages. In the first stage 300 data points from 100 patients were used to measure the IDVG (3 determinations for each patients). This utilized a one compartment model to describe the incremental plasma glucose decay curve following an intravenous bolus injection of glucose which, in turn, was used to derive the parameters of an equation for IDVG prediction following a single plasma sample. The second stage was a validation of the equation using a separate data set (150 points) from a further 50 patients. Results A one phase exponential decay model was well‐fitted for the IDVG‐postadministration glucose level curve, and indicated that the incremental glucose level at 3 min after i.v. glucose was best‐correlated to the IDVG compared with those at 1, 2, 4, 5 and 7 min postadministration. The formula of the IDVG was obtained from the curve: IDVG=24.44×e −0.0298×ΔGL +2.70, where ΔGL=incremental glucose level at 3 min after i.v. glucose. Another 150 samples showed that the measured‐IDVG from a one compartment model and predicted‐IDVG from the formula were 7.24±1.63 and 7.27±1.52 l, respectively, and that there was a significant correlation between the two IDVGs (r=0.966, P <0.0001). Conclusions Using an incremental glucose level at 3 min after i.v. glucose, we have established the reliable formula for determination of the IDVG which could be a clinically useful indicator of the central ECF volume.