Comparison of temperature responses to intravenous infusions of dextrose and fat emulsions.

A FEBRILE response to intravenous fat emulsion is the most frequent untoward side effect following short-term infusions. Though this side effect is probably not now common or severe enough to limit the clinical usefulness of intravenous fat emulsion, an understanding of its mechanism is important. One hypothesis offered is that the fever is a result of rapid metabolism of the infused fat with the resultant production of large amounts of heat, rather than being the result of some specific property of the fat in the emulsion. This hypothesis suggests that any infusion containing the same caloric equivalent as a standard infusion of fat, administered and metabolized at the same rate (or faster) would result in a similar number of febrile responses. The purpose of this study was to compare the temperature responses of a group of healthy subjects to isocaloric intravenous infusions of fat emulsion and dextrose. Intravenous fat emulsion is conunonly administered at the rate of 900 calories in fourhour intervals. If a normal adult receives intravenous dextrose at the maximum rate at which there is little urinary spillage, his rate of caloric intake will approach that afforded by a standard fat emulsion infusion. At an infusion rate of 0.8 g of dextrose per kg body weight per hour, one may expect up to 5 per cent urinary loss. Therefore, we administered 250 g of dextrose at this rate to insure a total retention