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[Perioperative perfusion in children: evaluation of a new perfusion solution]
1Département d'Anesthésie-Réanimation Chirurgicale, Hôpital Saint-Vincent-de-Paul, Paris.
Insights
A new intravenous dextrose solution (B66) resulted in lower postoperative blood glucose levels in children undergoing surgery compared to a 1% dextrose solution (RLG1). This finding is crucial for pediatric infusion therapy management.
Area of Science:
- Pediatric Anesthesiology
- Intravenous Fluid Therapy
- Metabolic Monitoring in Children
Background:
- Infusion therapy is critical for pediatric patients, especially during surgery.
- Dextrose solutions are commonly used, but their impact on blood glucose requires careful consideration in children.
- Evaluating new intravenous solutions like B66 is essential for optimizing patient care.
Purpose of the Study:
- To assess the efficacy and impact of a new intravenous dextrose solution (B66) in pediatric patients.
- To compare blood glucose, sodium, and protein concentrations between B66 and a 1% dextrose in lactated Ringer's solution (RLG1).
Main Methods:
- A randomized controlled trial involving 41 children (6 months to 11 years) undergoing elective surgery.
- Participants received either RLG1 (1% dextrose) or B66 (0.9% dextrose) via volumetric infusion pumps.
- Blood samples were collected at multiple time points to measure blood glucose, sodium, and protein.
Main Results:
- Postoperative blood glucose levels were significantly higher in the RLG1 group compared to the B66 group.
- Mean blood glucose at T1 was 6.8 +/- 1.5 mmol/L for RLG1 versus 5.2 +/- 1.0 mmol/L for B66.
- Total protein levels decreased postoperatively in both groups, with preoperative age-related differences noted.
Conclusions:
- The B66 intravenous solution (0.9% dextrose) appears to mitigate excessive postoperative hyperglycemia in pediatric surgical patients.
- B66 may be a preferred option for infusion therapy in children undergoing elective non-hemorrhagic surgery.
- Further research could explore long-term metabolic effects and optimal dextrose concentrations for different pediatric surgical scenarios.
Abstract:
A new intravenous solution (B66) containing 0.9% dextrose in water for infusion therapy in infants and children was assessed. Forty-one children, aged between 6 months and 11 years, scheduled for elective non haemorrhagic surgery, were randomly assigned to two groups: children in group I (n = 22) were given 1% dextrose in lactated Ringer's solution (RLG1), and those in group II (n = 19) the commercially available solution B66 (0.9% dextrose in lactated Ringer's solution). The fluids were administered throughout the study with volumetric infusion pumps (IVAC 541). The infusion rate was adapted to children's weight and age. Blood samples for blood glucose, sodium and protein concentration assessments were obtained at induction (T0), on arrival in the recovery room (T1), than 30 and 60 min later (T2 and T3). Preoperative blood glucose concentrations were within the normal range for all children except for two, who had asymptomatic hypoglycaemia (2.2 and 2.3 mmol.l-1). Postoperative blood glucose concentrations were higher in both groups. This increase was significantly greater in the RLG1 group than in the B66 group. The highest mean figures at T1 were 6.8 +/- 1.5 mmol.l-1 and 5.2 +/- 1.0 mmol.l-1 in the RLG1 and B66 groups respectively. Total protein levels decreased postoperatively significantly in both groups. Preoperative age-related differences in total protein concentrations were also observed postoperatively. Sodium concentrations remained unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)