A novel isotonic-balanced electrolyte solution with 1% glucose for perioperative fluid management in children- an animal experimental preauthorization study.
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).


CONCLUSIONS
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.
Witt
Lars
L
Klinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule Hannover, Hannover, Deutschland. Witt.Lars-Henrik@MH-Hannover.de
Osthaus
Wilhelm A
WA
Bünte
Christoph
C
Teich
Natascha
N
Hermann
Elvis J
EJ
Kaske
Martin
M
Koppert
Wolfgang
W
Sümpelmann
Robert
R
D000818:Animals; D001784:Blood Gas Analysis; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D002626:Chemistry, Pharmaceutical; D002648:Child; D004573:Electrolytes / Q000009:adverse effects*; D005260:Female; D005440:Fluid Therapy / Q000009:adverse effects; D005947:Glucose / Q000008:administration & dosage*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007427:Intracranial Pressure / Q000502:physiology; D007552:Isotonic Solutions / Q000009:adverse effects; D010092:Oximetry; D019990:Perioperative Care; D013552:Swine; D016896:Treatment Outcome; D014882:Water-Electrolyte Balance / Q000502:physiology
D001786:Blood Glucose; D004573:Electrolytes; D006454:Hemoglobins; D007552:Isotonic Solutions; D005947:Glucose