BACKGROUND Optimal composition and infusion rates of intravenous maintenance fluids for children undergoing surgery are not well defined. Avoidance of hypoglycaemia, ketosis, and hyponatraemia is important, and current guidelines recommend isotonic fluids containing 1.0-2.5% glucose. However, evidence for its safe use in infants is insufficient. The aim of this study was to investigate whether normoglycaemia is maintained in infants using a balanced electrolyte maintenance infusion with 1% glucose. METHODS Infants 1-12 months of age undergoing surgery were included in this prospective two-centre study. Intravenous maintenance fluid was given with infusion rates of 4-8 ml kg-1 h-1. Blood gas and ketone body analysis were performed at induction and at the end of anaesthesia. Plasma glucose concentration was monitored intraoperatively. RESULTS For the 365 infants included in this study, the median infusion rate of maintenance fluid was 3.97 (interquartile range 3.21-5.35) ml kg-1 h-1. Mean plasma glucose concentration increased from 5.3 mM at induction to 6.1 mM at the end of anaesthesia (mean difference 0.8 mM; 95% confidence interval 0.6-0.9, P<0.001). No cases of hypoglycaemia (<3.0 mM) occurred. Mean sodium concentration remained stable during anaesthesia. Chloride and ketone body concentration increased and base excess decreased, but these were within the normal range. CONCLUSIONS In infants undergoing surgery, maintenance infusion with a balanced electrolyte solution containing 1% glucose, at rates similar to those proposed by Holliday and Segar is a safe alternative with regards to homeostasis of glucose, electrolytes, and acid-base balance. CLINICAL TRIAL REGISTRATION ACTRN12619000833167.

中文翻译：

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含 1% 葡萄糖的平衡电解质溶液作为婴儿术中维持液：葡萄糖、电解质和酸碱稳态的前瞻性研究。


背景 接受手术的儿童静脉维持液的最佳成分和输注速率尚不明确。避免低血糖、酮症和低钠血症很重要，目前的指南推荐含有 1.0-2.5% 葡萄糖的等渗液体。然而，其在婴儿中安全使用的证据不足。本研究的目的是调查使用 1% 葡萄糖的平衡电解质维持输注婴儿是否维持正常血糖。方法 接受手术的 1-12 个月婴儿被纳入这项前瞻性双中心研究。静脉维持液的输注速率为 4-8 ml kg-1 h-1。在诱导时和麻醉结束时进行血气和酮体分析。术中监测血糖浓度。结果 本研究纳入的 365 名婴儿维持液的中位输注率为 3.97 （四分位距 3.21-5.35） ml kg-1 h-1。平均血浆葡萄糖浓度从诱导时的 5.3 mM 增加到麻醉结束时的 6.1 mM （平均差 0.8 mM;95% 置信区间 0.6-0.9，P<0.001）。未发生低血糖病例 （<3.0 mM）。麻醉期间平均钠浓度保持稳定。氯和酮体浓度增加，碱过量减少，但这些都在正常范围内。结论 在接受手术的婴儿中，维持输注含有 1% 葡萄糖的平衡电解质溶液，其速率与 Holliday 和 Segar 提出的相似，是葡萄糖、电解质和酸碱平衡稳态的安全替代方案。临床试验注册 ACTRN12619000833167。