Stability of 0.5% Glucose-Containing Balanced Electrolyte Solutions for Patients on Ketogenic Diets: A Laboratory StudyFunding This study was funded by departmental resources.
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.
No ethical approval was necessary for this laboratory study.
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.
Received: 31 March 2020
Accepted: 28 May 2020
25 August 2020 (online)
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