title: A novel isotonic-balanced electrolyte solution with 1% glucose for perioperative fluid management in children- an animal experimental preauthorization study.
abstract: 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.
authors.affiliation: Klinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule Hannover, Hannover, Deutschland. Witt.Lars-Henrik@MH-Hannover.de
authors.forename: Lars
authors.initials: L
authors.lastname: Witt
authors.forename: Wilhelm A
authors.initials: WA
authors.lastname: Osthaus
authors.forename: Christoph
authors.initials: C
authors.lastname: Bünte
authors.forename: Natascha
authors.initials: N
authors.lastname: Teich
authors.forename: Elvis J
authors.initials: EJ
authors.lastname: Hermann
authors.forename: Martin
authors.initials: M
authors.lastname: Kaske
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Koppert
authors.forename: Robert
authors.initials: R
authors.lastname: Sümpelmann
mesh_terms: 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
chemical_list: D001786:Blood Glucose; D004573:Electrolytes; D006454:Hemoglobins; D007552:Isotonic Solutions; D005947:Glucose