Continuous Infusion of Dextrose to Protect Vital Structures During Thyroid Radiofrequency Ablation Procedures.

When do we need to use continuous infusion D5W for adequate hydrodissection protective effects?

Ma Y. et al Eur. Thyroid Journal October 2021

DR. Guttler’s Comments on the article:

1. Single bolus of D5W has a short half life in the body. Hydrodissection is a key technique to protect vital structures near the target nodule.

2. It has short term protection to vital structures.

3. Paper looks at large volume infusion of D5W ability to keep 3-5 mm gap from vital structures.

4. 166 patients studied with different volumes.(< 40 ml and > 40 ml.)

5. 51 patients with 10-40 ml injections and 116 with larger infusions

6. High volume D5W could be protective of vital structures around the thyroid in cases with larger nodules.

7. Animal studies show how 20 ml D5W diffused in 10 minutes from around the thyroid went to the kidneys and to the chest, where it disappeared from the chest in 24 hours.

8. At my center we decide how much D5W is needed based on the size of the target lesion and proximity to vital structures.

9. Most smaller nodules only need a single 20 ml bolus of D5W.

10. Call me for an evaluation if you are a candidate for thyroid RFA for your benign nodule or thyroid cancer.

11. 310-393-8860 or email to thyroid.manager@thyroid.com.

12. Ask for Alicia

13. Dr.G