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Vol. 89. Num. 2.01 August 2018
Pages 77-124
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Vol. 89. Num. 2.01 August 2018
Pages 77-124
Original Article
DOI: 10.1016/j.anpede.2017.10.003
A comparison of post-surgical plasma glucose levels in patients on fluids with different glucose concentrations
Comparación de niveles de glucemia postoperatoria usando sueros con diferente concentración de glucosa
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Isabel Martínez Carapeto
Corresponding author
belisamc@gmail.com

Corresponding author.
, José Domingo López Castilla, Reyes Fresneda Gutiérrez
Unidad de Gestión Clínica de Cuidados Críticos y Urgencias Pediátricas, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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Tables (2)
Table 1. Characteristics of the sample under study at the time of admission.
Table 2. Mean plasma glucose levels in each group at each time point.
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Abstract
Objective

To compare plasma glucose levels and incidence of hyperglycaemia in the post-operative period after general surgery using fluids with different glucose.

Methodology

A randomised, open-label, non-blind, clinical trial was conducted on patients admitted to Paediatric Intensive Care Unit after elective surgery. The inclusion criteria were from 6 months to 14 years of age, with a weight greater than 6kg, onset glucose level >60mg/dL, and a signed informed consent, with no oral intake and maintenance intravenous fluid therapy using fluids with 3.3% or 5% glucose. Plasma glucose levels were measured before surgery, on admission, and 8, 24, and 48h, with the mean glucose levels and incidence of hyperglycaemia (glucose level >150mg/dL) in both groups being compared.

Results

A total of 60 patients received glucose/saline 1/3 (51mEq/L sodium and 33g/L glucose), and 70 glucose/saline 5/0.9% (154mEq/L sodium and 50g/L glucose). Mean glucose levels were higher in the group receiving glucose 5%, with no statistical difference. There was no significant difference in the incidence of hyperglycaemia; 8h: 26% in the 3.3% group vs. 21.3% in the 5% group (P=.63); 24h: 20% vs. 22.7% (P=.8); and 48h: 19% vs. 23.1% (P=.78).

Conclusions

The use of fluids with 3.3% glucose in the post-operative period of general surgery maintains mean glucose levels in a similar range to that of patients receiving fluids with 5% glucose, with no difference in the incidence of hyperglycaemia.

Keywords:
Hyperglycaemia
Post-operative
Maintenance intravenous fluid therapy
Resumen
Objetivo

Comparar los niveles de glucemia e incidencia de hiperglucemia en el postoperatorio de cirugía general usando sueros con diferente concentración de glucosa.

Metodología

Ensayo clínico aleatorizado, abierto, no ciego, en pacientes no diabéticos, que ingresan en Cuidados Intensivos Pediátricos tras cirugía electiva, de 6 meses a 14 años, peso superior a 6kg, glucemia>60mg/dl y firma de consentimiento informado, manteniéndose a dieta con sueroterapia de mantenimiento intravenosa mediante suero con glucosa al 3,3 o 5%. Se determinan niveles de glucemia preoperatoria, al ingreso, y a las 8, 24 y 48h, comparando los valores medios y la incidencia de hiperglucemia (glucemia >150mg/dl) en ambos grupos.

Resultados

Un total de 60 pacientes recibieron suero glucosalino 1/3 (51mEq/l de sodio y 33g/l de glucosa) y 70 pacientes suero glucosalino 5/0,9% (154mEq/l de sodio y 50g/l de glucosa). La glucemia media fue mayor en el grupo al 5%, sin diferencia estadística. No hubo diferencia en la incidencia de hiperglucemia; 8h: 26% del grupo 3,3% vs. 21,3% del grupo 5% (p=0,63); 24h: 20% vs. 22,7% (p=0,8); 48h: 19% vs. 23,1% (p=0,78).

Conclusiones

En el postoperatorio de cirugía general, el uso de soluciones glucosadas al 3,3% consigue niveles de glucemia similares a los detectados en pacientes que reciben suero con glucosa 5%, con una incidencia de hiperglucemia similar.

Palabras clave:
Hiperglucemia
Postoperatorio
Fluidoterapia intravenosa de mantenimiento

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