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A novel isotonic‐balanced electrolyte solution with 1% glucose for perioperative fluid management in children‐ an animal experimental preauthorization study
Author(s) -
WITT LARS,
OSTHAUS WILHELM A.,
BÜNTE CHRISTOPH,
TEICH NATASCHA,
HERMANN ELVIS J.,
KASKE MARTIN,
KOPPERT WOLFGANG,
SÜMPELMANN ROBERT
Publication year - 2010
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/j.1460-9592.2010.03349.x
Subject(s) - medicine , isotonic solutions , hyponatremia , hematocrit , electrolyte , base excess , tonicity , acidosis , perioperative , metabolic acidosis , anesthesia , hemoglobin , saline , endocrinology , chemistry , electrode
Summary Background: The recommendations for perioperative maintenance fluid in children have been adapted from hypotonic to isotonic electrolyte solutions with lower glucose concentrations (1–2.5% instead of 5%) to avoid hyponatremia or hyperglycemia. Objective: The objective of this prospective animal study was to determine the margin of safety of a novel isotonic‐balanced electrolyte solution with 1% glucose (BS‐G1) in comparison with normal saline with 1% glucose (NS‐G1) in the case of accidental hyperhydration with a focus on acid–base electrolyte balance, glucose concentration, osmolality and intracranial pressure in piglets. Methods: Ten piglets (bodyweight 11.8 ± 1.8 kg) were randomly assigned to receive either 100 ml·kg −1 of BS‐G1 or NS‐G1 within one hour. Before, during and after fluid administration, electrolytes, lactate, hemoglobin, hematocrit, glucose, osmolality and acid–base parameters were measured. Results: Unlike BS‐G1, administration of NS‐G1 produced mild hyperchloremic acidosis (base excess BS‐G1 vs NS‐G1, baseline 1.9 ± 1.7 vs 2.9 ± 0.9 mmol·l −1 , study end 0.2 ± 1.7 vs −2.7 ± 0.5 mmol·l −1 , P < 0.05, chloride BS‐G1 vs NS‐G1 baseline 102.4 ± 3.4 vs 102.0 ± 0.7 mmol·l −1 , study end 103.4 ± 1.8 vs 109.0 ± 1.4 mmol·l −1 P < 0.05). The addition of 1% glucose led to moderate hyperglycemia ( P < 0.05) with a concomitant increase in serum osmolality in both groups ( P < 0.05). Conclusion: Both solutions showed a wide margin of safety in the case of accidental hyperhydration with less acid–base electrolyte changes when using BS‐G1. This novel solution could therefore enhance patient’s safety within the scope of perioperative volume management.