The impact of modified fluid gelatin 4% in a balanced electrolyte solution on plasma osmolality in children—A noninterventional observational study

Autor: Daniel Rudolf, Lars Witt, Dietmar Boethig, Vanessa Rigterink, Rolf Zander, Robert Sümpelmann, Nils Dennhardt
Rok vydání: 2022
Předmět:
Zdroj: Pediatric Anesthesia. 32:961-966
ISSN: 1460-9592
1155-5645
Popis: Intravenous fluids for perioperative infusion therapy should be isotonic to maintain the body fluid homeostasis in children. Modified fluid gelatin 4% in a balanced electrolyte solution has a theoretical osmolarity of 284 mosmol LWe thus hypothesized that the infusion of gelatin would be expected to decrease plasma osmolality. We performed an in-vitro experiment and an in-vivo study to evaluate the impact of gelatin on the osmolality in children.In the in-vitro experiment, full blood samples were diluted with gelatin 4% or albumin (50 g LIn the in-vitro experiment, 65 gradually diluted blood samples from five volunteers (age 25-55 years) were analyzed. The dilution with gelatin caused no significant changes in osmolality between 0% and 100%. Compared with gelatin, the osmolality in the albumin group was significantly lower between 50% and 100% dilution (p .05). In the in-vivo study, 221 children (age 21.4 ± 30 months) were included. After gelatin infusion, the osmolality increased significantly (mean change 4.3 ± 4.8 [95% CI 3.7-4.9] mosmol kg HGelatin in a balanced electrolyte solution has isotonic characteristics in-vitro and in-vivo, despite the low theoretical osmolarity, probably caused by the (unmeasured) negative charges in the gelatin molecules contributing to the plasma osmolality. For a better evaluation of the (real) tonicity of gelatin-containing solutions, we suggest to calculate the osmolality (mosmol kg HClinicalTrials.gov (ID: NCT02495285).
Databáze: OpenAIRE
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