Thrombophlebitis following intravenous glucose in the cold.

In an effort to characterize the role of carbohydrate metabolism during the hypermetabolic state associated with whole body cooling, oral (n = 6) and intravenous (iv; n = 3) glucose tolerance tests (GTT) were performed in nude subjects. Unexpectedly, 1-2 wks after the completion of their iv GTT (50% dextrose) in the cold, superficial thrombophlebitis was diagnosed in all 3 subjects. No subject developed thrombophlebitis after the oral GTT in the warm and cold, nor after the iv GTT in the warm. Since this complication was not observed in further testing with isotonic iv solutions under identical conditions in the cold as above, we conclude that the adverse reaction is the result of an interaction between whole body cooling or vasoconstriction and the hypertonicity of the dextrose solution. Environmental physiologists and medical officers should be aware of this complication.