Zhang Hongyi, Wang Pei, Li Ruohui, Zhou Chonggao, Chen Kuai, Wen Zhe, Liu Yuanmei, Liu Xiang, Chen Qi, Tou Jinfa, Ren Hongxia, Zhang Mingman, Chen Feng, Feng Jiexiong
Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, Hubei, China.
Department of Fetal and Neonatal Surgery, Hunan Children's Hospital, Changsha, Hunan, China.
Pediatr Surg Int. 2025 Apr 9;41(1):107. doi: 10.1007/s00383-025-06021-x.
To evaluate the efficacy and safety of perioperative sodium bicarbonate Ringer's solution (BRS) in biliary atresia (BA) infants undergoing Kasai portoenterostomy (KPE).
This study was conducted in 11 pediatric medical centers across China from 2020 to 2022. Infants were randomly assigned to either the BRS group (n = 64) or the control crystalloids group (n = 56) for perioperative fluid management. Anesthesia and fluid management were standardized. Primary outcomes were arterial blood pH, bicarbonate, and base excess; secondary outcomes included changes in other blood parameters and adverse events.
The baseline characteristics of the two groups were similar. During KPE, BRS more effectively maintained arterial blood pH, bicarbonate, and base excess during KPE with no electrolyte abnormalities. Three days after KPE, the BRS group had lower potassium levels. Drug safety evaluation showed no significant differences, and the incidence of adverse events was comparable.
BRS effectively maintained the acid-base status of BA infants during KPE. With no significant safety concerns, it is suggested that BRS is a suitable option for perioperative fluid management.
评估围手术期碳酸氢钠林格氏液（BRS）在接受Kasai肝门空肠吻合术（KPE）的胆道闭锁（BA）婴儿中的疗效和安全性。
本研究于2020年至2022年在中国11家儿科医疗中心进行。将婴儿随机分为BRS组（n = 64）或对照晶体液组（n = 56）进行围手术期液体管理。麻醉和液体管理标准化。主要结局指标为动脉血pH值、碳酸氢盐和碱剩余；次要结局指标包括其他血液参数的变化和不良事件。
两组的基线特征相似。在KPE期间，BRS在KPE期间更有效地维持动脉血pH值、碳酸氢盐和碱剩余，且无电解质异常。KPE后三天，BRS组的钾水平较低。药物安全性评估显示无显著差异，不良事件发生率相当。
BRS在KPE期间有效维持了BA婴儿的酸碱状态。由于没有明显的安全问题，建议BRS是围手术期液体管理的合适选择。
