WEAKNESS, NEUROPATHY, AND COMA FOLLOWING TOTAL PARENTERAL NUTRITION IN UNDER-FED OR STARVED RATS - RELATIONSHIP TO BLOOD HYPEROSMOLARITY AND BRAIN WATER-LOSS

  • 1 January 1978
    • journal article
    • research article
    • Vol. 92  (4) , 521-528
Abstract
The continuous infusion of a concentrated, high-caloric glucose solution i.v. into underfed or 3 day starved rats at a rate of 390 kcal/kg per day resulted in hypophosphatemia, muscular weakness, neuropathy, lethargy, occasional convulsions and eventual coma and death. This sequence of events was not observed in similarly infused normal rats. It is a model of a fatal parenteral nutrition syndrome which occurs in undernourished patients. Rats in coma had an 8-fold increase in the blood glucose level, a 1.6-fold increase in serum osmolarity, a 16-20% decrease in brain water content and normal blood ketones. A lag phase of at least 8 h and often 12-24 h occurred following the start of the hyperosmotic glucose infusion before the blood glucose began to accumulate progressively and the syndrome developed. The onset of the syndrome could be prevented by the administration of large amounts of insulin required to keep the blood sugar from exceeding 250 mg/dl. The rat model of the fatal hyperalimentation syndrome is a form of hyperglycemic, hyperosmolar nonketotic coma caused by brain dehydration.

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