Abstract
The problem of choosing an infusion solution, especially in starting therapy, for various critical conditions, remains debatable, especially in children with specifics of water-electrolyte metabolism, which determines their tendency to imbalance of water and electrolytes.
Objectives. Comparative evaluation of the succinate-containing solution and the malate-containing solution as a starting infusion therapy in the early postoperative period in children.
Materials and methods. A randomized prospective study in 40 patients with an ASA II–III score who underwent an operation. In the first group “R” 20 children receive succinate-containing solution and in the second group “S” 20 children receive malate-containing solution. At the study stages inter- and intra- group differences were estimated by the dynamics of the water-electrolyte and acid-base conditions, phase angle values — the calculated integral indicator of the state of the membranes of cell structures, and basal metabolism.
Results. No significant differences between groups at all stages of the study were obtained. However, in group “S” there was a dynamic, statistically significant by 180 minutes after the start of fluid administration, a decrease in the phase angle by 4.1 %, despite the fact that in group “R” the deviations were not significant.
Conclusion. There were no statistically significant differences between the solutions used as starting infusion therapy drugs in the early postoperative period in the indicated modes, and they can be used equally well. However, the noted statistically significant changes in the phase angle in the group with malate-containing solution indicated a tendency to it is negative effect on the state of cell structures, which, apparently, should be taken into account with more significant volumes and duration of fluid administration.
References
- Boer C., Bossers S.M., Koning N.J. Choice of fluid type: physiological concepts and perioperative indications. Br. J. Anaesth. 2018; 120(2): 384–396. DOI: 10.1016/j.bja.2017.10.022
- Khan M.F., Siddiqui K.M., Asghar M.A. Fluid choice during perioperative care in children: A survey of present-day proposing practice by anesthesiologists in a tertiary care hospital. Saudi J. Anaesth. 2018; 12(1): 42–45. DOI: 10.4103/sja.SJA_258_17
- Raina R., Sethi S.K., Wadhwani N., Vemuganti M., Krishnappa V., Bansal Sh.B. Fluid Overload in Critically Ill Children. Front. Pediatr. 2018; 6: 306. (Published online 29.10.2018) DOI: 10.3389/fped.2018.00306
- Sümpelmann R., Becke K., Zander R., Witt L. Perioperative fluid management in children: can we sum it all up now? Curr. Opin. Anaesthesiol. 2019; 32(3): 384–391. DOI: 10.1097/ACO.0000000000000727
- Kim H.J., Choi S.H., Eum D., Kim S.H. Is perioperative colloid infusion more effective than crystalloid in preventing postoperative nausea and vomiting? A systematic review and meta-analysis. Medicine (Baltimore). 2019; 98(7): e14339. DOI: 10.1097/MD.0000000000014339
- Hahn R.G. Adverse effects of crystalloid and colloid fluids. Anaesthesiol Intensive Ther. 2017; 49(4): 303–308. DOI: 10.5603/AIT.a2017.0045
- Lex D.J., Tóth R., Czobor N.R., Alexander S.I., Breuer T., Sápi E., Szatmári A., Székely E., Gál J., Székely A. Fluid Overload Is Associated With Higher Mortality and Morbidity in Pediatric Patients Undergoing Cardiac Surgery. Pediatr. Crit. Care Med. 2016; 17(4): 307–14. DOI: 10.1097/PCC.0000000000000659
- Raina R., Sethi S.K., Wadhwani N., Vemuganti M., Krishnappa V., Bansal Sh.B. Fluid Overload in Critically Ill Children. Frontiers in Pediatrics. 2018; 6: 306. DOI: 10.3389/fped.2018.00306
- George J.F. Fluid and Electrolyte Homeostasis in Infants and Children. Pediatric Program. 2003; 51: 155–170.
- O’Brien F., Walker I.A. Fluid homeostasis in the neonate. Paediatr. Anaesth. 2014; 24(1): 49–59. DOI: 10.1111/pan.12326
- Садовская И.К. Особенности водно-электролитного баланса и их механизмы у недоношенных детей. Вестник СамГУ — Естественнонаучная серия. 2006; 6/2(46): 33–40. [Sadovskaya I.K. Features of water-electrolyte balance and their mechanisms in premature babies. Bulletin of SamSU — Natural Science Series. 2006; 6/2(46): 33–40. (In Russ)]
- Malcolm A.H., Patricio E.R., Aaron L.F. Fluid therapy for children: facts, fashions and questions. Arch. Dis. Child. 2007; 92(6): 546–550. DOI: 10.1136/adc.2006.106377
- Fluid and Electrolytes (Na, Cl and K). J. Pediatric Gastroenterology and Nutrition. 2005; 41: S33–S38. DOI: 10.1097/01.mpg.0000181846.93628.0e
- Zieg J. Pathophysiology of Hyponatremia in Children. Frontiers in Pediatrics. 2017; 5: 213. DOI: 10.3389/fped.2017.00213
- Delpachitra M.R., Namachivayam S.P., Millar J., Delzoppo C., Butt W.W. A Case-Control Analysis of Postoperative Fluid Balance and Mortality After Pediatric Cardiac Surgery. Pediatr. Crit. Care Med. 2017; 18(7): 614–622. DOI: 10.1097/PCC.0000000000001170
- Лазарев В.В., Ермолаева К.Р., Кочкин В.С., Цыпин Л.Е., Попова Т.Г., Бологов А.А., Ваганов Н.Н. Влияние сукцинатсодержащего раствора на уровень основного обмена в периоперационном периоде у детей. Анестезиология и реаниматология. 2015; 60(1): 38–41. [Lazarev V.V., Ermolaeva K.R., Kochkin V.S., Tsypin L.E., Popova T.G., Bologov A.A., Vaganov N.N. The effect of succinate-containing solution on the level of basal metabolism in the perioperative period in children. Anesteziol Reanimatol. 2015; 60(1): 38–41. (In Russ)]
- Сухоруков В.П., Мазина Н.К., Булдакова А.В. Фармакоэкономическая оценка препарата энергопротекторного типа — реамберина в периоперационном обеспечении резекций печени. Вестник интенсивной терапии. 2005; 5: 68–69. [Sukhorukov V.P., Mazina N.K., Buldakova A.V. Pharmacoeconomic evaluation of an energy-protective type drug — reamberin in the perioperative provision of hepatectomy. Intensive care herald. 2005; 5: 68–69. (In Russ)]
- Ливанов Г.А., Батоцыренов Б.В., Васильев С.А., Андрианов А.Ю., Баранов Д.В., Неженцева И.В. Окислительный дистресс и его коррекция реамберином у больных с острым отравлением смесью психотропных веществ. Общая реаниматология. 2013; 9(5): 18. DOI: 10.15360/1813-9779-2013-5-18 [Livanov G.A., Batotsyrenov B.V., Vasiliev S.A., Andrianov A.Yu., Baranov D.V., Nezhentseva I.V. Oxidative distress and its correction with reamberin in patients with acute poisoning with a mixture of psychotropic substances. General Reanimatology. 2013; 9(5): 18. (In Russ)]
- Александрович Ю., Пшениснов К. Инфузионные антигипоксанты при критических состояниях у детей. Общая реаниматология. 2014; 10(3): 59–74. DOI: 10.15360/1813-9779-2014-3-59-74. [Aleksandrovich Yu., Pshenisnov K. Infusion antihypoxants in critical conditions in children. General Reanimatology. 2014; 10(3): 59–74. (In Russ)]
- Галушка С.В., Назаров Б.Ф., Власенко А.В. Применение растворов гидроксиэтилкрахмала и реамберина в комплексном лечении тяжелого гестоза. Анестезиология и реаниматология. 2004; 6: 41–44. [Galushka S.V., Nazarov B.F., Vlasenko A.V. The use of solutions of hydroxyethyl starch and reamberin in the complex treatment of severe gestosis. Anesteziol Reanimatol. 2004; 6: 41–44. (In Russ)]
- Шах Б.Н., Лапшин В.Н., Кырнышев А.Г., Смирнов Д.Б., Кравченко–Бережная Н.Р. Метаболические эффекты субстратного антигипоксанта на основе янтарной кислоты. Общая реаниматология. 2014; 10(1): 33–42. DOI: 10.15360/1813-9779-2014-1-33-42. [Shah B.N., Lapshin V.N., Kirnishev A.G., Smirnov D.B., Kravchenko-Berezhnaya N.R. The metabolic effects of succinic acid-based substrate antihypoxant. General Reanimatology. 2014; 10(1): 33–42. (In Russ)]
- Орлов Ю.П., Лукач В.Н., Глущенко А.В. Реамберин в программе интенсивной терапии у пациентов с распространенным перитонитом. Новости хирургии. 2013; 21(5): 58–64. [Orlov Y.P., Lukach V.N., Gluschenko A.V. Reamberin in the intensive therapy program in patients with generalized peritonitis. Novosti Khirurgii. 2013; 21(5): 58–64. (In Russ)]

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.