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

作者：Witt Lars^*; Osthaus Wilhelm A; Buente Christoph; Teich Natascha; Hermann Elvis J; Kaske Martin; Koppert Wolfgang; Suempelmann Robert

来源：Paediatric Anaesthesia, 2010, 20(8): 734-740.

DOI：10.1111/j.1460-9592.2010.03349.x

• balanced electrolyte solution
• normal saline
• children
• margin of safety
• acid-base
• fluid management

P>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 center dot 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 center dot l-1, study end 0.2 +/- 1.7 vs -2.7 +/- 0.5 mmol center dot l-1, P < 0.05, chloride BS-G1 vs NS-G1 baseline 102.4 +/- 3.4 vs 102.0 +/- 0.7 mmol center dot l-1, study end 103.4 +/- 1.8 vs 109.0 +/- 1.4 mmol center dot l-1P < 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.

• 出版日期2010-8