Glukosehaltige Infusionslösungen werden traditionell in der Pädiatrie eingesetzt, sie finden sich auch etwa auf jedem dritten deutschen Rettungsdienstfahrzeug. Es wird von drei fatalen Zwischenfällen bei Kleinkindern berichtet, die akzidentell oder unkritisch Glukoseinfusionen erhielten. In der Notfallmedizin und Anästhesiologie sind Glukoseinfusionen auf wenige Ausnahmeindikationen beschränkt. Der nichtindizierte Einsatz führt beim kritisch Kranken zu erhöhter Morbidität. Falls beim indizierten Einsatz solche Lösungen erforderlich sind, können sie durch Zugabe von Glukose 40 % hergestellt werden. Glukose als Infusion sollte zur Vermeidung von fatalen Verwechslungen nicht routinemäßig vorgehalten werden. Es wird deshalb die kostengünstigere Vorhaltung von Ringer-Laktat-Lösung oder von Vollelektrolytlösungen empfohlen.
Glucose-containing drip solutions are used traditionally in the paediatrics, they are also found possibly on each 3rd German rescue vehicle. We report about three fatal incidents with infants, who received Glucose drips akzidentally or uncritically. In emergency medicine and Anesthesiology Glucose drips are limited to few special indications, on the other hand, the non-indicated application in the critically sick child results in raised morbidity. Because such solutions could be produced simply by addition of Glucose 40 %, they should not be stored to the avoidance of fatal mistakes. We recommend more economical storing of Ringer's lactate solution or of full electrolytic solutions on rescue vehicles.
Key words
glucose infusion - paediatrics - adverse (side) effects - emergency medicine
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Korrespondenz
Dr. med. Matthias Thöns
Arzt für Anästhesiologie, Notfall- und Palliativmedizin
Wiesenstraße 14
58452 Witten
