Does the initial distribution volume of glucose reflect the shift of the central extracellular fluid volume after major surgical procedures?

Our experimental studies indicated that the initial distribution volume of glucose (IDVG) reflects the central extracellular fluid (ECF) volume status including plasma rather than glucose metabolism. The present study was designed to discover whether the IDVG follows the postoperative fluid shift from the peripheral to the central ECF compartment. Five grams of glucose and 25mg of indocyanine green (ICG) were infused simultaneously over 30 seconds through the central venous line in 21 patients following either subtotal esophagectomy or major vascular surgery. A total of 104 daily comparisons between the IDVG and plasma volume determined by the ICG dilution method (PV-ICG) were performed. Two estimates were calculated using a one compartment model utilizing plasma values from 3 to 7 minutes postinfusion for the IDVG, and from 3 to 11 minutes postinfusion for PV-ICG. Two estimates increased on the 3rd postoperative day (P<0.05), even though body weight remained unchanged. A linear correlation was obtained between two estimates (r=0.68, n=104, P<0.001). Our results demonstrate that two estimates followed the fluid shift, and suggest that the IDVG is useful to evaluate central ECF volume status following major surgical procedures.