Comparative analysis of using balanced and normal saline solutions as an intraoperative therapy in newborns
- Authors: Nasser M.M.1, Kucherov Y.I.2,3, Zhirkova Y.V.2,3
-
Affiliations:
- Saratov Regional Children’s Clinical Hospital
- Pirogov Russian National Research Medical University
- G. N. Speransky Children’s Municipal Clinical Hospital
- Issue: Vol 9, No 2 (2019)
- Pages: 41-49
- Section: Original Study Articles
- Submitted: 15.08.2019
- Accepted: 15.08.2019
- Published: 15.08.2019
- URL: https://rps-journal.ru/jour/article/view/545
- DOI: https://doi.org/10.30946/2219-4061-2019-9-2-41-49
- ID: 545
Cite item
Full Text
Abstract
The purpose of the study was to compare the values of acid base balance, electrolytic and hemodynamic parameters in newborns depending on the composition of intraoperative infusion therapy. The study was done in 60 newborns who were given Staerofundin ISO basic infusion (10 ml/kg/hour) in group I (n=31) and normal saline solution in group II (n=29) during a surgery.
Results: following the surgery, no differences in pH values were observed between the groups, moderate metabolic disturbances were found. In Group II, levels of bicarbonates decreased from 22.2 to 20.5 (р=0.047). By the end of the surgery, normal electrolyte composition was found more frequently in group I (29%) as compared to group II (20%). Hypopotassemia (34.5% and 22.6%), hyperpotassemia (44.8% and 25.8%) and hyperchloremia (63% and 51.7%) were found more frequently in group II as compared to group I, respectively. To achieve the target level of blood pressure, the bolus was injected to 29% (n=9) of children from group I and 17.2% (n=5) of children from group II. Adrenergic agonists were used in 42% of children from group I and 27.6% of children from group II (р=0,038). There were no differences between the cumulative doses.
Conclusion. Sterofundin and normal saline solution demonstrated equivalent values of effectiveness and produced similar effect on the values of acid base balance, electrolytic and hemodynamic parameters during the intraoperative period in newborns.
Keywords
About the authors
Marianna M. Nasser
Saratov Regional Children’s Clinical Hospital
Author for correspondence.
Email: mnasser@bk.ru
Doctor of the department of pediatric anesthesiology and intensive care
Volskaya 6, Saratov, Russia, 410028; phone: +7(927)152–60–52
РоссияYurii I. Kucherov
Pirogov Russian National Research Medical University; G. N. Speransky Children’s Municipal Clinical Hospital
Email: ykucherov@mail.ru
Dr. Sci (Med), Professor of the department of pediatric surgery, RNRMU; branch manager of the department of emergency surgery of G. N. Speransky City Children’s Hospital № 9
Shmitovsky av. 29, Moscow, Russia, 123317; phone: +7(985)774–41–46
РоссияYuliya V. Zhirkova
Pirogov Russian National Research Medical University; G. N. Speransky Children’s Municipal Clinical Hospital
Email: zhirkova@mail.ru
Dr. Sci (Med), Professor of the department of pediatric anesthesiology and intensive therapy RNRMU; doctor-anesthesiologist of the department of emergency surgery of G. N. Speransky City Children’s Hospital № 9
Shmitovsky av. 29, Moscow, Russia, 123317; phone: +7(905)505–54–72
РоссияReferences
- Arumainathan R., Stendall C., Visram A. Management of fluids in neonatal surgery. BJA Education. 2018; 18(7): 199-203. doi: 10.1016/j.bjae.2018.03.006
- Anand K. J., Hansen D. D., Hickey P. R. Hormonal-metabolic stress responses in neonates undergoing cardiac surgery. Anesthesiology. 1990: 73(4): 661-70
- Володин Н. Н. Неонатология: национальное руководство: краткое издание. Москва: ГЭОТАР-Медиа;2019, 896 с.
- Gormley M. D., Crean M. B. Basic principles of anaestesia for neonates and infants. British Journal of Anaesthesia. 2005; 1(5): 130-3. doi: 10.1093/bjacepd/1.5.130
- Sumpelmann R., Karin B., Brenner S., Breschan C. Perioperative intravenous fluid therapy in children: guidelines from the Association of the Scientific Medical Societies in Germany. Pediatric Anesthesia. 2016; 27(1): 10-8. doi: 10.1111/pan.13007
- Ting Xu., Jianmin Z. Perioperative fluid administration in children: is there consensus? Pediatric Anesthesia. 2017; 27: 4-6. doi: 10.1111/pan.1307
- Lais H., Camacho N., Otavio Costa Auler J., A. Bloomstone J., Cannesson M. Perioperative fluid therapy: a statement from the international Fluid Optimization Group. Perioperative Medicine. 2015; 18(4): 543-54. doi: 10.1186/s13741-015-0014-z
- Nkilly G. Е., Michelet D., Hilly J. Postoperative decrease in plasma sodium concentration after infusion of hypotonic intravenous solutions in neonatal surgery. British Journal of Anaesthesia. 2014; 112(3): 540-5. doi: 10.1093/bja/aet374
- Frances O’Brien, Isabeau A. Fluid homeostasis in the neonate. Pediatric Anesthesia. 2013; 24(1): 49-9. doi: 10.1111/pan.12326
- Baraton L., Ancel P. Y., Flamant С., Orsonneau J. L., Darmaun D., Rozé J. C. Impact of changes in serum sodium levels on 2-year neurologic outcomes for very preterm neonates. Pediatrics. 2009; (124):655-61. doi: 10.1542/peds.2008-3415
- Arieff A. I., Ayus J., Fraser C. L. Hyponatraemia and death or permanent brain damage in healthy children. BMJ. 1992; (304): 1218-22. doi: 10.1136/bmj.304.6836.1218
- Sumpelmann R., Karin B., Crean P., Jöhr M., Lönnqvist P. A., Strauss J. M., Veyckemans F. European consensus statement for intraoperative fluid therapy in children. European Journal of Anaesthesiology. 2011; 28(9): 637-9. doi: 10.1097/EJA.0b013e3283446bb8