Kurzdauernde Infusionstherapie im Kindesalter.Ein Vergleich individuell gemischter mit kommerziell erhältlichen Infusionslösungen

Data of parenteral sodium dosage in healthy children recommended by several textbooks vary by the factor 4. Therefore, we studied the effect of low and high i.v. dosage administered in 5-5.5% glucose for 12 hrs to probands without renal disease. Group 1: n = 13; Na 2.2 +/- 0.4, K 1.7 +/- 0.2, Cl 4.2 +/- 0.6 mmol/kg/d, individually composed solutions. Group 2: n = 17; Na 5.1 +/- 1.3, K 1.6 +/- 0.5, Cl 5.8 +/- 1.5, acetate 2.4 +/- 0.6 mmol/kg/d; Ca, Mg, malate, glycerol phosphate below 0.3 mmol/kg/d; commercial ready-for-use mixtures. Compared to the control period, the excretion of Na into the urine was unchanged in group 1 during the infusion but significantly lowered in group 2. Regression analysis reveals that infusion of 2.7 mmol Na/kg/d would have given a balanced sodium balance. The real parenteral requirement, however, may be below this value, as the excretion of Na during the control period indicates that the probands in both groups were overloaded with Na before the beginning of the study. During infusion, the renal clearance of creatinine was unchanged in group 1 but significantly lowered in group 2 (131 +/- 58 vs. 94 +/- 38 ml/min/1.73 m2; p less than 0.01). We would like to recommend to elucidate the mechanism and the clinical significance of this effect before using the commercial solution in clinical routine.