An investigation of intraoperative maintenance fluid containing glucose 10 mg/ml to infants (1-12 moths old).

The main objective of this observational study is to investigate if normoglycemia is maintained when a near isotonic maintenance fluid containing 1 % glucose is given intraoperatively to infants (1-12 moths of age). (n=375). The administered 1% glucose near-isotonic maintenance fluid will be given as a continous infusion during the whole intraoperative period ,5 ml/kg/hour for minor surgery, 7 ml/kg/hour for moderate surgery and 10 ml/kg/hour for major surgery. This is the only intravenous maintenance fluid that will be given intraoperatively. Using near-isotonic 1% glucose solution for this age group is not yet clinical practice at our department , mostly due to fear of hypoglycemia. However, this solution is widely recommended, including European Society of Pediatric anesthesia. This study focus upon a specific age cohort with possible risk of hypoglycemia. and include a relatively large number of patients. We believe that the recommendations can be substantiated with the results from this study. Plasma glucose concentration (blood-gas analysis) will be determined at induction of anesthesia and then every 30 minutes during surgery. In the blood-gas analysis also sodium will be analysed. The concentration of ketone bodies will be measured at induction and at the end of surgery. The time of fasting will be determined and related to glucose- and ketoneconcentration. In a subgroup of subjects undergoing major surgery with expected duration > 60 minutes, endogenous glucose production and energy production will be determined using stabile isotope (6.6-D2-glucose) and indirect calorimetry respectively.