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Neuropediatrics 2020; 51(06): 397-400
DOI: 10.1055/s-0040-1715634
Original Article

Stability of 0.5% Glucose-Containing Balanced Electrolyte Solutions for Patients on Ketogenic Diets: A Laboratory Study

Sebastian Heiderich 
1   Clinic for Anesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany
,
Nils Dennhardt
1   Clinic for Anesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany
,
Hans Hartmann
2   Clinic for Pediatric Kidney, Liver, and Metabolic Diseases, Hannover Medical School, Hannover, Germany
,
Gerhard Joseph Kluger
3   Clinic for Neuropediatrics and Neurorehabilitation, Epilepsy Center for Children and Adolescents, Schön Klinik Vogtareuth, Vogtareuth, Germany
4   Research Institute “Rehabilitation, Transition, and Palliation,” PMU Salzburg, Salzburg, Austria
,
Robert Sümpelmann
1   Clinic for Anesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany
,
Thomas Herberhold
3   Clinic for Neuropediatrics and Neurorehabilitation, Epilepsy Center for Children and Adolescents, Schön Klinik Vogtareuth, Vogtareuth, Germany
› Author Affiliations Funding This study was funded by departmental resources.
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Abstract

Purpose Ketogenic diets (KDs) are used to treat epilepsies resistant to pharmacotherapy or some inborn errors of metabolism. For prolonged anesthesia, use of balanced electrolyte solutions (BESs) supplemented with 0.5% glucose has been advocated to maintain ketosis while preventing hypoglycemia. Unfortunately, there is no BES containing 0.5% glucose available from pharmacies. In a laboratory study, we investigated the physical and chemical stability of different BES mixtures containing 0.5% glucose.

Methods In total, six approaches were chosen to create a BES with 0.5% glucose: three different glucose-free BESs were supplemented with glucose. Additionally, commercially available BES containing 1% glucose was diluted with three different glucose-free BESs to obtain a solution containing 0.5% glucose. Turbidity, pH, electrical conductivity, and macroscopic appearance of these solutions were measured immediately, at 24 hours, and after 7 days, and were compared with the original BES.

Results Turbidity, pH, and electrical conductivity, as well as macroscopic appearance did not exceed the changes of the controls.

Conclusions No signs of incompatibility reactions could be observed in a 1-week time period. Our study supports the stability of the examined BES containing 0.5% glucose for prolonged anesthesia in patients on KD. Clinical studies are needed to evaluate if BES containing 0.5% glucose is superior in patients on KDs.

Keywords

ketogenic diet - epilepsy - fluid therapy - balanced electrolyte solution - compatibility

Ethics

No ethical approval was necessary for this laboratory study.


Disclosures

R. S. received fees for speeches and funds for research from B. Braun Melsungen AG, Melsungen, Germany. H. H., G. K., and T. H. received travel bursaries and honoraria from Nutricia, Erlangen, Germany.




Publication History

Received: 31 March 2020

Accepted: 28 May 2020

Article published online:
25 August 2020

© 2020. Thieme. All rights reserved.

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