The impact of modified fluid gelatin 4% in a balanced electrolyte solution on plasma osmolality in children—A noninterventional observational study

Abstract

Background: Intravenous fluids for perioperative infusion therapy should be isotonic to maintain the body fluid homeostasis in children. Modified fluid gelatin 4% in a balanced electrolyte solution has a theoretical osmolarity of 284 mosmol L −1 , and a real osmolality of 264 mosmol kg H 2 O −1 . Because both values are lower than those of 0.9% saline or plasma, gelatin would be expected to be hypotonic in-vitro and in-vivo. Aim:We thus hypothesized that the infusion of gelatin would be expected to decrease plasma osmolality. We performed an in-vitro experiment and an in-vivo study to evaluate the impact of gelatin on the osmolality in children.

Alpha‐Gal Syndrome: An Underrated Serious Disease and a Potential Future Challenge

“…[26,31] Gelatin is a complex combination of proteins and peptides produced through partial hydrolysis of collagen extracted from the skin, bone, or connective tissue of bovine or porcine animals or fish. [8] Gelatin is widely utilized as a food ingredient or additive, [32] a substitute for colloidal plasma in medical usage, [33,34] and a stabilizer in vaccines. [35] The majority of patients allergic to red meat were also sensitized to gelatin, with a subset showing clinical allergies to both.…”

“…However, the pathogenic link between tick bites and sensitization to red meat, 𝛼-Gal, and gelatin (with or without clinical reactivity) remains unclear. [36] Numerous cases of allergy or anaphylaxis to gelatincontaining food, [32] vaccines, [37,38] and intravascular volume expanders, [33,34,39] and gelatin-based hemostatic agents have been reported. [40,41] The duration of onset depends on the route by which gelatin was introduced.…”

“…Numerous cases of allergy or anaphylaxis to gelatin‐containing food, [ 32 ] vaccines, [ 37 , 38 ] and intravascular volume expanders, [ 33 , 34 , 39 ] and gelatin‐based hemostatic agents have been reported. [ 40 , 41 ] The duration of onset depends on the route by which gelatin was introduced.…”

A brief history of crystalloids: the origin of the controversy

“…In fact, in a clinical trial in adults following kidney transplantation, Ringer's lactate was associated with less acidosis and hyperkalemia ( 42 ). In addition, it has been used as a solution for diluting human albumin (reducing a 20% concentration to 4%), proving to be safe and isotonic, possibly related to negative charges in the gelatin molecules contributing to plasma osmolality ( 43 ). However, this solution should not be used in children with head trauma because it has been associated with worse outcomes and even increased mortality ( 44 ).…”