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

Paediatr Anaesth. 2010 Aug;20(8):734-40. doi: 10.1111/j.1460-9592.2010.03349.x.

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).

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.

MeSH terms

  • Animals
  • Blood Gas Analysis
  • Blood Glucose / metabolism
  • Blood Pressure / physiology
  • Chemistry, Pharmaceutical
  • Child
  • Electrolytes / adverse effects*
  • Female
  • Fluid Therapy* / adverse effects
  • Glucose / administration & dosage*
  • Hemoglobins / metabolism
  • Humans
  • Intracranial Pressure / physiology
  • Isotonic Solutions* / adverse effects
  • Oximetry
  • Perioperative Care
  • Swine
  • Treatment Outcome
  • Water-Electrolyte Balance / physiology

Substances

  • Blood Glucose
  • Electrolytes
  • Hemoglobins
  • Isotonic Solutions
  • Glucose