A novel isotonic balanced electrolyte solution with 1% glucose for perioperative fluid management in children- an animal experimental pre- authorisation study Running title: A novel balanced electrolyte solution

Lars Witt (1) , Wilhelm Alexander Osthaus (2) , Christoph Buente (1) , Natascha Teich (2) , Elvis Hermann (3) , Martin Kaske (4) , Wolfgang Koppert (2) , Robert Sümpelmann (2)

1 Klinik für Anästhesiologie und Intensivmedizin
2 Klinik für Anästhesiologie und Intensivmedizin
3 Klinik für Neurochirurgie
4 Klinik für Rinder

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%) in order to avoid hyponatraemia or hyperglycaemia. 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 to normal saline with 1% glucose (NS-G1) in 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 ± 1.8kg) 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, haemoglobin, haematocrit, glucose, osmolality and acid-base parameters were measured. Results: Unlike BS-G1, administration of NS-G1 produced mild hyperchloraemic 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-1p< 0.05). The addition of 1% glucose led to moderate hyperglycaemia (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.

Mots clés: Medicine

Lars Witt, Wilhelm Alexander Osthaus, Christoph Buente, Natascha Teich, Elvis Hermann, et al.. A novel isotonic balanced electrolyte solution with 1% glucose for perioperative fluid management in children- an animal experimental pre- authorisation study Running title: A novel balanced electrolyte solution. Pediatric Anesthesia, 2010, 20 (8), pp.734. ⟨10.1111/j.1460-9592.2010.03349.x⟩. ⟨hal-00560696⟩