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Effects of a restrictive fluid regimen in pediatric patients undergoing major abdominal surgery.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Mandee, Sahatsa Butmangkun, Wassana Aroonpruksakul, Naiyana Tantemsapya, Niramol Von Bormann, Benno Suraseranivongse, Suwannee
Description	Country affiliation: Thailand Author Affiliation: Mandee S ( Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.)
Abstract	OBJECTIVE: To investigate the effects of restrictive fluid regimen during major abdominal surgery in pediatric patients. BACKGROUND: In adults, a restrictive and goal-directed regimen as opposed to a liberal-fluid regimen results in better outcomes after various major surgical procedures. The different ratio of body fluid distribution in pediatric patients from those of adults may influence different needs of fluid. METHODS: This stratified, randomized, controlled trial was conducted in 25 pediatric patients (mean age <3 years) undergoing major abdominal surgery. Patients were allocated to two groups based on their perioperative fluid management. 'control group' received maintenance plus deficit plus interstitial space replacement plus ongoing loss, whereas 'restrictive group' had a similar treatment, but were given no interstitial space replacement. Intraoperative fluid resuscitation was guided by hemodynamics and base excess. Parameters recorded included hemodynamic variables, the volume and type of intravenous fluid, blood chemistry (including lactate, base excess, and electrolyte), chest X-ray, body weight, complications, and return of bowel function. RESULTS: Patients in control group needed significantly less additional fluid for resuscitation compared to restrictive group (0.62 ± 3.51 ml · kg(-1) · h(-1) vs 5.04 ± 4.16 ml · kg(-1) · h(-1) ; P = 0.012). In restrictive group, heart rates were higher (P = 0.012) and base excess showed more negative results (P = 0.049). There were no differences between the groups in terms of the total volume requirement, postoperative kidney function, chest X-ray, variation of body weight and the postoperative outcomes. CONCLUSIONS: Volume preload corresponding with an estimated interstitial space replacement was suitable for application to pediatric patients undergoing major abdominal surgery.
File Format	HTM / HTML
ISSN	11555645
Issue Number	5
Volume Number	25
e-ISSN	14609592
Journal	Pediatric Anesthesia
Language	English
Publisher	Wiley-Blackwell
Publisher Date	2015-05-01
Publisher Place	France
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Fluid Therapy Perioperative Care Research Support, Non-u.s. Gov't Body Weight Humans Water-electrolyte Balance Child, Preschool Infant Male Randomized Controlled Trial Epidemiology Journal Article Abdomen Surgery Discipline Anesthetics Female Statistics & Numerical Data Hemodynamics Postoperative Complications Child Methods Infant, Newborn
Content Type	Text
Resource Type	Article
Subject	Anesthesiology and Pain Medicine Pediatrics, Perinatology and Child Health

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