On Tue, 9 Nov 2004 19:09:15 GMT, Jaques d'Alltrades
wrote:

The honey or jam was to help it go down, but in restoring
some of the sugar which the liver under attack wasn't providing, it gave
some credence to the antidote hypothesis)

Latterly, intravenous sugars are (unless I'm *VERY* out of date) always
administered to restore the blood-sugar levels to normal...

People with liver failure are very vulnerable to hypoglycaemia and
this is watched for very very closely. Treatment is usually by a
steady infusion of 10% glucose with higher concentrations as
needed.Intermittent boluses are used but only when needed not as a
regular item.


Any one on ITU would almost certainly receive glucose as a routine
infusion

...rather than just routinely.

By the way you don't need ( indeed there are reasons not to) mix
glucose with saline.

Maybe other sugars are used now, or other preservative. I *WAS* quoting
from the (presumably first edition) 1959 impression.

The difference between fluid management and ITU care from 1959 and the
present day is as big as the diferences between the PC you sre sitting
in front of now and the one you would have used in 1960. Glucose ( AKA
dextrose ) is virtually the only one used. Mannitol very rarely for
special reasons but nowt else



Sorry - while copying that I missed out the 4% (glucose)

4% glucose 0.18% saline is mainly used in paediatrics for volume
reasons it means in kids you can match salt given to the childs size.


I think we got to this point because someone suggested that there was
still no treatment - no sure-fire cure, I'd agree, but treatments which
improve the chances of survival there are.

Improve survival yes but my point is these treatments are non specific
and as such very chancy. If you are poisoned with nerve gas ( or
insecticide) you get pralidoxime which is a direct antidote. Morphine
you get naloxone, paracetamol N-acetylcysteamine and so on ( but for
very few more).

With Amanita poisoning you get those things which help your liver and
kidneys cope until they heal themselves. Your survival hinges much
more on time taken to recognise the poison than on a "cure". To call
this a treatment is to elevate routine supportive measures which I
agree are vital and successful to the level of an antidote they are
not.

Neil