Influence of fluid regimens on perioperative blood-glucose concentrations in neonates.
Blood concentrations of glucose were measured during surgery and during the first 8 h after operation in 30 neonates undergoing major surgery during the first week of life. Fifteen of the neonates were given Ringer-acetate as the only crystalloid peroperative fluid; to the other 15, 10% glucose i.v. was administered during surgery. In the Ringer-acetate group, mean (SD) blood concentration of glucose increased from 3.1 (2.0) to 4.3 (2.4) mmol litre-1 during surgery. The corresponding increase in the glucose-supplemented group was 3.4 (1.5) to 6.3 (2.2) mmol litre-1. In the Ringer-acetate group, peroperative blood concentrations of glucose were found to be low if a preoperative glucose infusion was interrupted at the start of anaesthesia. Hypoglycaemia occurred in both groups, but more often in the group given Ringer-acetate only (3/15 vs 1/15). Hypoglycaemia was found only in neonates less than 48 h of age and during the first 1 h of anaesthesia only. Monitoring of blood concentrations of glucose and adjustment of the glucose infusion appears to be desirable during and after surgery in neonates.
Larsson
L E
LE
Department of Paediatric Anaesthesia and Intensive Care, Ostra Sjukhuset, Göteborg, Sweden.
Nilsson
K
K
Niklasson
A
A
Andreasson
S
S
Ekström-Jodal
B
B
D001786:Blood Glucose / Q000032:analysis*; D000013:Congenital Abnormalities / Q000601:surgery*; D005440:Fluid Therapy; D005947:Glucose / Q000008:administration & dosage*; D006801:Humans; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D007432:Intraoperative Period; D007552:Isotonic Solutions / Q000008:administration & dosage; D011184:Postoperative Period; D011300:Preoperative Care / Q000379:methods
D001786:Blood Glucose; D007552:Isotonic Solutions; C028570:Ringer's acetate; D005947:Glucose