Liberal VS Goal-directed Intraoperative Fluid Therapy in Pediatric Patients
Overview
- Phase
- Phase 2
- Intervention
- conventional liberal fluid regimen
- Conditions
- Adverse Anesthesia Outcome
- Sponsor
- Mahidol University
- Enrollment
- 40
- Locations
- 1
- Primary Endpoint
- Proportion of patients with 5% postoperative weight gain between control group and study group
- Last Updated
- 14 years ago
Overview
Brief Summary
The objectives of this study are 1) to investigate the influence of different fluid regimen (Liberal regimen versus Goal directed therapy regimen) on postoperative outcome such as weight gain, delayed gut function recovery, pneumonia and 2) to ascertain the reliability of USCOM monitoring using serum lactate and base deficit as control parameters.
Detailed Description
Liberal regimen = maintenance fluid(4/2/1) + deficit fluid + replacement of third space loss (\>,=10ml/kg/h) Goal directed therapy regimen = maintenance fluid + deficit fluid + fluid replaced by hemodynamic monitoring guided.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Body weight \< 15 kg
- •Under going major abdominal surgery such as tumor removal, gut obstruction, pull through, etc. under general anesthesia and invasive arterial pressure monitoring if justified
- •ASA \< or = 3
- •Duration of surgery \> or = 2 hours
Exclusion Criteria
- •Cardiopulmonary disease
- •Renal insufficiency
- •Intraoperative complications such as massive bleeding, severe hypotension, prolonged need for mandatory ventilation
- •reoperation
Arms & Interventions
control group
Control group will receive conventional liberal fluid regimen with crystalloid Liberal fluid regimen = Maintenance fluid + fasting fluid + dehydration + third space loss Maintenance fluid = (4X BW 1-10 kg) + (2X1BW11-20 kg) + (1X BW 0ver 21 kg) Fasting fluid = maintenance fluid X fasting duration
Intervention: conventional liberal fluid regimen
study group
Study group will receive restricted fluid regimen (the same as control group except third space replacement) plus goal directed fluid therapy to maintain adequate CO guided by USCOM as shown in diagram (figure 1). Figure 1 goal directed fluid therapy SVV = Stroke volume variation SVI = Stroke volume index CI = Cardiac index
Intervention: restricted fluid regimen
Outcomes
Primary Outcomes
Proportion of patients with 5% postoperative weight gain between control group and study group
Time Frame: 24 hours
Body weight
Secondary Outcomes
- Amount of intraoperative fluid(1 day)
- Postoperative morbidity(4 days)