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Glucose versus lactated Ringer's solution during pediatric cardiac surgery
A Aouifi1, J Neidecker, C Vedrinne
1Service d'Anesthésie-Réanimation Chirurgicale, Hopital Cardiovasculaire et Pneumologique L Pradel, Lyon, France.
Journal of Cardiothoracic and Vascular Anesthesia
|June 1, 1997
Summary
Glucose-free fluids during pediatric cardiac surgery risk hypoglycemia. Moderate intraoperative glucose infusion is safe and prevents dangerous low blood sugar levels in children undergoing heart repair.
Area of Science:
- Pediatric Cardiac Surgery
- Anesthesiology
- Metabolic Regulation
Background:
- Intraoperative fluid composition in pediatric cardiac surgery is debated.
- The impact of glucose-containing fluids on blood glucose and insulin levels requires clarification.
Purpose of the Study:
- To compare the effects of glucose versus glucose-free fluid infusions on blood glucose and insulin levels.
- To evaluate the safety and efficacy of intraoperative glucose administration in pediatric cardiac surgery.
Main Methods:
- Prospective, randomized, blinded study in a cardiovascular university center.
- Forty non-diabetic children (4-10 kg) undergoing cardiac surgery with cardiopulmonary bypass.
- Comparison of lactated Ringer's solution versus 5% glucose infusion at 3 mL/kg/h.
Main Results:
- Three patients receiving glucose-free fluids experienced severe hypoglycemia before cardiopulmonary bypass.
- Blood glucose levels increased post-cardiopulmonary bypass in both groups, with minimal differences.
- No patient exhibited hyperglycemia exceeding 239 mg/dL.
Conclusions:
- Glucose withdrawal during pediatric cardiac surgery can lead to critical hypoglycemia.
- Moderate intraoperative glucose administration (2.5 mg/kg/min) is safe and does not cause significant hyperglycemia.