Carbohydrate urine glucose measurement

Although hematological, biochemical, hepatic, and renal parameters are not specific for DNOC exposure, these parameters may be measured to determine disease states caused by DNOC. One animal study demonstrated changes in these parameters following oral exposure to DNOC for intermediate-duration (Den Tonkelaar et al. 1983). Based on DNOC s mechanism (uncoupling of exudative phosphorylation), urinary ketone levels and urine and blood glucose levels may be monitored for effects on carbohydrate metabolism. 

The early phase of SBS is associated with large day-to-day variations in fluid and electrolyte losses. Strict output records should be assessed, as well as all intake including intravenous medications. Initially, it is recommended to start a standard PN solution that meets the patient s maintenance metabolic, fluid, and electrolyte needs, and a separate intravenous replacement solution is typically necessary to keep the patient euvolemic based on actual fluid losses. Insensible losses should be estimated between 300 and 800 mL/day above measured output, and daily urine output should be kept at least 1 L. As fluid and electrolyte losses stabilize over time it becomes possible to incorporate these replacement requirements into the PN solution. The PN solution typically is composed of standard crystalline amino acids, glucose, and intravenous lipids. A generic caloric breakdown for SBS patients based on a need of 30 to 40 kcaV kg per day may be 1.5 g/kg of protein per day, approximately 20% to 30% of calories from intravenous lipids, and the remainder of calories from carbohydrates. An example of a PN formula for the patient with SBS is given in Table 139-2. 

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