A comparison of post-surgical plasma glucose levels in patients on fluids with different glucose concentrations

Objective: To compare plasma glucose levels and incidence of hyperglycaemia in the postoperative 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 6 kg, onset glucose level > 60 mg/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 48 h, with the mean glucose levels and incidence of hyperglycaemia (glucose level > 150 mg/dL) in both groups being compared. Results: A total of 60 patients received glucose/saline 1/3 (51 mEq/L sodium and 33 g/L glucose), and 70 glucose/saline 5/0.9% (154 mEq/L sodium and 50 g/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; 8 h: 26% in the 3.3% group vs. 21.3% in the 5% group (P = .63); 24 h: 20% vs. 22.7% (P = .8); and 48 h: 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. (C) 2017 Asociacion Espanola de Pediatria. Published by Elsevier Espana, S.L.U.