A randomised controlled trial of Hartmann's solution versus half normal saline in postoperative paediatric spinal instrumentation and craniotomy patients
Objective To compare the difference in plasma sodium at 16–18 h following major surgery in children who were prescribed either Hartmann's and 5% dextrose or 0.45% saline and 5% dextrose. Design A prospective, randomised, open label study. Setting The paediatric intensive care unit (650 admissio...
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| Veröffentlicht in: | Archives of disease in childhood 2012-06, Vol.97 (6), p.491-496 |
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| creator | Coulthard, Mark G Long, Debbie A Ullman, Amanda J Ware, Robert S |
| description | Objective To compare the difference in plasma sodium at 16–18 h following major surgery in children who were prescribed either Hartmann's and 5% dextrose or 0.45% saline and 5% dextrose. Design A prospective, randomised, open label study. Setting The paediatric intensive care unit (650 admissions per annum) in a tertiary children's hospital in Brisbane, Australia. Patients The study group comprised 82 children undergoing spinal instrumentation, craniotomy for brain tumour resection, or cranial vault remodelling. Interventions Patients received either Hartmann's and 5% dextrose at full maintenance rate or 0.45% saline and 5% dextrose at two-thirds maintenance rate. Main outcomes measures Primary outcome measure: plasma sodium at 16–18 h postoperatively; secondary outcome measure: number of fluid boluses administered. Results Mean postoperative plasma sodium levels of children receiving 0.45% saline and 5% dextrose were 1.4 mmol/l (95% CI 0.4 to 2.5) lower than those receiving Hartmann's and 5% dextrose (p=0.008). In the 0.45% saline group, seven patients (18%) became hyponatraemic (Na |
| doi_str_mv | 10.1136/archdischild-2011-300221 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_1015248016</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A295966635</galeid><sourcerecordid>A295966635</sourcerecordid><originalsourceid>FETCH-LOGICAL-b519t-b297d370263802cc1b83c982d6956921cdfc2c2c20593e1260a2870c00af55f63</originalsourceid><addsrcrecordid>eNqNkctu1DAUhiMEokPhFZAlhGAT8CVx7GU1XIqoKIjLgo3lcZyOB8cOtlPRR-FtOekMBbFCXtiyv3PO7_-vKkTwM0IYf66T2fYum63zfU0xITXDmFJyq1qRhgu4aprb1QpjzGophDiq7uW8w5hQIdjd6ohSKhvOxar6eYKSDn0cXbY9MjGUFL2HY0lOexQHdKpTGXUITzLK0c_FxYAubcpzRlvtBxRiGoHM2rtgkQtoirnEySZd3KVFk7a909DNoDy5AKQLuaR5tKHo62YwHhkQ4WKJ4xUUFAdv-X51Z9A-2weH_bj6_Orlp_VpfXb--s365KzetESWekNl17MOU84EpsaQjWBGCtpz2XJJiekHQ5eFW8ksoRxrKjpsMNZD2w6cHVdP932nFL_PNhcFXhjrvQ42zlkRTFraCEwW9NE_6C7OCf4ElABrG8ybhar31IX2VrmwmGp_FLP4emEViF-fqxMqW8k5Zy3wYs-bFHNOdlBTcqNOVzBaLXGrv-NWS9xqHzeUPjwImjej7W8Kf-cLwOMDoLOBtMBm4_IfrpW06665g2aXQevNu07fFO9Y16p3X9bq60ciX3zo3qu3wLM9vxl3_y_3F8TP2Fc</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1828840646</pqid></control><display><type>article</type><title>A randomised controlled trial of Hartmann's solution versus half normal saline in postoperative paediatric spinal instrumentation and craniotomy patients</title><source>MEDLINE</source><source>BMJ Journals - NESLi2</source><creator>Coulthard, Mark G ; Long, Debbie A ; Ullman, Amanda J ; Ware, Robert S</creator><creatorcontrib>Coulthard, Mark G ; Long, Debbie A ; Ullman, Amanda J ; Ware, Robert S</creatorcontrib><description>Objective To compare the difference in plasma sodium at 16–18 h following major surgery in children who were prescribed either Hartmann's and 5% dextrose or 0.45% saline and 5% dextrose. Design A prospective, randomised, open label study. Setting The paediatric intensive care unit (650 admissions per annum) in a tertiary children's hospital in Brisbane, Australia. Patients The study group comprised 82 children undergoing spinal instrumentation, craniotomy for brain tumour resection, or cranial vault remodelling. Interventions Patients received either Hartmann's and 5% dextrose at full maintenance rate or 0.45% saline and 5% dextrose at two-thirds maintenance rate. Main outcomes measures Primary outcome measure: plasma sodium at 16–18 h postoperatively; secondary outcome measure: number of fluid boluses administered. Results Mean postoperative plasma sodium levels of children receiving 0.45% saline and 5% dextrose were 1.4 mmol/l (95% CI 0.4 to 2.5) lower than those receiving Hartmann's and 5% dextrose (p=0.008). In the 0.45% saline group, seven patients (18%) became hyponatraemic (Na <135 mmol/l) at 16–18 h postoperatively; in the Hartmann's group no patient became hyponatraemic (p=0.01). No child in either fluid group became hypernatraemic. Conclusions The postoperative fall in plasma sodium was smaller in children who received Hartmann's and 5% dextrose compared to those who received 0.45% saline and 5% dextrose. It is suggested that Hartmann's and 5% dextrose should be administered at full maintenance rate postoperatively to children who have undergone major surgery in preference to hypotonic fluids.</description><identifier>ISSN: 0003-9888</identifier><identifier>EISSN: 1468-2044</identifier><identifier>DOI: 10.1136/archdischild-2011-300221</identifier><identifier>PMID: 22294668</identifier><identifier>CODEN: ADCHAK</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health</publisher><subject>Adolescent ; Back surgery ; Biological and medical sciences ; Brain Neoplasms - surgery ; Brain tumors ; Care and treatment ; Caregivers ; Case reports ; Child ; Child, Preschool ; Children & youth ; Complications ; Craniotomy ; Creatinine ; Electrolytes ; Female ; Fluid Therapy - methods ; Fluids ; General aspects ; Glucose - therapeutic use ; Hospitals ; Humans ; Hyponatremia ; Instrumentation ; Intensive care ; Intensive Care Units, Pediatric ; Intravenous therapy ; Isotonic Solutions - therapeutic use ; Laboratories ; Maintenance ; Male ; Medical sciences ; Medical Services ; Methods ; Miscellaneous ; Organic Chemistry ; Patient outcomes ; Patients ; Pediatrics ; Plasma ; Postoperative care ; Postoperative complications ; Postoperative Period ; Prevention ; Prevention and actions ; Prospective Studies ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Sodium ; Sodium - blood ; Sodium Chloride - therapeutic use ; Spinal instrumentation ; Spine - surgery ; Surgery ; Urine</subject><ispartof>Archives of disease in childhood, 2012-06, Vol.97 (6), p.491-496</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><rights>2015 INIST-CNRS</rights><rights>Copyright: 2012 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b519t-b297d370263802cc1b83c982d6956921cdfc2c2c20593e1260a2870c00af55f63</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://adc.bmj.com/content/97/6/491.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://adc.bmj.com/content/97/6/491.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,776,780,3183,23550,27901,27902,77343,77374</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25927768$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22294668$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Coulthard, Mark G</creatorcontrib><creatorcontrib>Long, Debbie A</creatorcontrib><creatorcontrib>Ullman, Amanda J</creatorcontrib><creatorcontrib>Ware, Robert S</creatorcontrib><title>A randomised controlled trial of Hartmann's solution versus half normal saline in postoperative paediatric spinal instrumentation and craniotomy patients</title><title>Archives of disease in childhood</title><addtitle>Arch Dis Child</addtitle><description>Objective To compare the difference in plasma sodium at 16–18 h following major surgery in children who were prescribed either Hartmann's and 5% dextrose or 0.45% saline and 5% dextrose. Design A prospective, randomised, open label study. Setting The paediatric intensive care unit (650 admissions per annum) in a tertiary children's hospital in Brisbane, Australia. Patients The study group comprised 82 children undergoing spinal instrumentation, craniotomy for brain tumour resection, or cranial vault remodelling. Interventions Patients received either Hartmann's and 5% dextrose at full maintenance rate or 0.45% saline and 5% dextrose at two-thirds maintenance rate. Main outcomes measures Primary outcome measure: plasma sodium at 16–18 h postoperatively; secondary outcome measure: number of fluid boluses administered. Results Mean postoperative plasma sodium levels of children receiving 0.45% saline and 5% dextrose were 1.4 mmol/l (95% CI 0.4 to 2.5) lower than those receiving Hartmann's and 5% dextrose (p=0.008). In the 0.45% saline group, seven patients (18%) became hyponatraemic (Na <135 mmol/l) at 16–18 h postoperatively; in the Hartmann's group no patient became hyponatraemic (p=0.01). No child in either fluid group became hypernatraemic. Conclusions The postoperative fall in plasma sodium was smaller in children who received Hartmann's and 5% dextrose compared to those who received 0.45% saline and 5% dextrose. It is suggested that Hartmann's and 5% dextrose should be administered at full maintenance rate postoperatively to children who have undergone major surgery in preference to hypotonic fluids.</description><subject>Adolescent</subject><subject>Back surgery</subject><subject>Biological and medical sciences</subject><subject>Brain Neoplasms - surgery</subject><subject>Brain tumors</subject><subject>Care and treatment</subject><subject>Caregivers</subject><subject>Case reports</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children & youth</subject><subject>Complications</subject><subject>Craniotomy</subject><subject>Creatinine</subject><subject>Electrolytes</subject><subject>Female</subject><subject>Fluid Therapy - methods</subject><subject>Fluids</subject><subject>General aspects</subject><subject>Glucose - therapeutic use</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hyponatremia</subject><subject>Instrumentation</subject><subject>Intensive care</subject><subject>Intensive Care Units, Pediatric</subject><subject>Intravenous therapy</subject><subject>Isotonic Solutions - therapeutic use</subject><subject>Laboratories</subject><subject>Maintenance</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medical Services</subject><subject>Methods</subject><subject>Miscellaneous</subject><subject>Organic Chemistry</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Plasma</subject><subject>Postoperative care</subject><subject>Postoperative complications</subject><subject>Postoperative Period</subject><subject>Prevention</subject><subject>Prevention and actions</subject><subject>Prospective Studies</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Sodium</subject><subject>Sodium - blood</subject><subject>Sodium Chloride - therapeutic use</subject><subject>Spinal instrumentation</subject><subject>Spine - surgery</subject><subject>Surgery</subject><subject>Urine</subject><issn>0003-9888</issn><issn>1468-2044</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkctu1DAUhiMEokPhFZAlhGAT8CVx7GU1XIqoKIjLgo3lcZyOB8cOtlPRR-FtOekMBbFCXtiyv3PO7_-vKkTwM0IYf66T2fYum63zfU0xITXDmFJyq1qRhgu4aprb1QpjzGophDiq7uW8w5hQIdjd6ohSKhvOxar6eYKSDn0cXbY9MjGUFL2HY0lOexQHdKpTGXUITzLK0c_FxYAubcpzRlvtBxRiGoHM2rtgkQtoirnEySZd3KVFk7a909DNoDy5AKQLuaR5tKHo62YwHhkQ4WKJ4xUUFAdv-X51Z9A-2weH_bj6_Orlp_VpfXb--s365KzetESWekNl17MOU84EpsaQjWBGCtpz2XJJiekHQ5eFW8ksoRxrKjpsMNZD2w6cHVdP932nFL_PNhcFXhjrvQ42zlkRTFraCEwW9NE_6C7OCf4ElABrG8ybhar31IX2VrmwmGp_FLP4emEViF-fqxMqW8k5Zy3wYs-bFHNOdlBTcqNOVzBaLXGrv-NWS9xqHzeUPjwImjej7W8Kf-cLwOMDoLOBtMBm4_IfrpW06665g2aXQevNu07fFO9Y16p3X9bq60ciX3zo3qu3wLM9vxl3_y_3F8TP2Fc</recordid><startdate>20120601</startdate><enddate>20120601</enddate><creator>Coulthard, Mark G</creator><creator>Long, Debbie A</creator><creator>Ullman, Amanda J</creator><creator>Ware, Robert S</creator><general>BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health</general><general>BMJ Publishing Group</general><general>BMJ Publishing Group Ltd</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88B</scope><scope>88E</scope><scope>88I</scope><scope>8A4</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>CJNVE</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>LK8</scope><scope>M0P</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEDU</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20120601</creationdate><title>A randomised controlled trial of Hartmann's solution versus half normal saline in postoperative paediatric spinal instrumentation and craniotomy patients</title><author>Coulthard, Mark G ; Long, Debbie A ; Ullman, Amanda J ; Ware, Robert S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b519t-b297d370263802cc1b83c982d6956921cdfc2c2c20593e1260a2870c00af55f63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adolescent</topic><topic>Back surgery</topic><topic>Biological and medical sciences</topic><topic>Brain Neoplasms - surgery</topic><topic>Brain tumors</topic><topic>Care and treatment</topic><topic>Caregivers</topic><topic>Case reports</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children & youth</topic><topic>Complications</topic><topic>Craniotomy</topic><topic>Creatinine</topic><topic>Electrolytes</topic><topic>Female</topic><topic>Fluid Therapy - methods</topic><topic>Fluids</topic><topic>General aspects</topic><topic>Glucose - therapeutic use</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hyponatremia</topic><topic>Instrumentation</topic><topic>Intensive care</topic><topic>Intensive Care Units, Pediatric</topic><topic>Intravenous therapy</topic><topic>Isotonic Solutions - therapeutic use</topic><topic>Laboratories</topic><topic>Maintenance</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medical Services</topic><topic>Methods</topic><topic>Miscellaneous</topic><topic>Organic Chemistry</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Plasma</topic><topic>Postoperative care</topic><topic>Postoperative complications</topic><topic>Postoperative Period</topic><topic>Prevention</topic><topic>Prevention and actions</topic><topic>Prospective Studies</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Sodium</topic><topic>Sodium - blood</topic><topic>Sodium Chloride - therapeutic use</topic><topic>Spinal instrumentation</topic><topic>Spine - surgery</topic><topic>Surgery</topic><topic>Urine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Coulthard, Mark G</creatorcontrib><creatorcontrib>Long, Debbie A</creatorcontrib><creatorcontrib>Ullman, Amanda J</creatorcontrib><creatorcontrib>Ware, Robert S</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Education Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>Education Periodicals</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Education Collection</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Education Database</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Education</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of disease in childhood</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Coulthard, Mark G</au><au>Long, Debbie A</au><au>Ullman, Amanda J</au><au>Ware, Robert S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A randomised controlled trial of Hartmann's solution versus half normal saline in postoperative paediatric spinal instrumentation and craniotomy patients</atitle><jtitle>Archives of disease in childhood</jtitle><addtitle>Arch Dis Child</addtitle><date>2012-06-01</date><risdate>2012</risdate><volume>97</volume><issue>6</issue><spage>491</spage><epage>496</epage><pages>491-496</pages><issn>0003-9888</issn><eissn>1468-2044</eissn><coden>ADCHAK</coden><abstract>Objective To compare the difference in plasma sodium at 16–18 h following major surgery in children who were prescribed either Hartmann's and 5% dextrose or 0.45% saline and 5% dextrose. Design A prospective, randomised, open label study. Setting The paediatric intensive care unit (650 admissions per annum) in a tertiary children's hospital in Brisbane, Australia. Patients The study group comprised 82 children undergoing spinal instrumentation, craniotomy for brain tumour resection, or cranial vault remodelling. Interventions Patients received either Hartmann's and 5% dextrose at full maintenance rate or 0.45% saline and 5% dextrose at two-thirds maintenance rate. Main outcomes measures Primary outcome measure: plasma sodium at 16–18 h postoperatively; secondary outcome measure: number of fluid boluses administered. Results Mean postoperative plasma sodium levels of children receiving 0.45% saline and 5% dextrose were 1.4 mmol/l (95% CI 0.4 to 2.5) lower than those receiving Hartmann's and 5% dextrose (p=0.008). In the 0.45% saline group, seven patients (18%) became hyponatraemic (Na <135 mmol/l) at 16–18 h postoperatively; in the Hartmann's group no patient became hyponatraemic (p=0.01). No child in either fluid group became hypernatraemic. Conclusions The postoperative fall in plasma sodium was smaller in children who received Hartmann's and 5% dextrose compared to those who received 0.45% saline and 5% dextrose. It is suggested that Hartmann's and 5% dextrose should be administered at full maintenance rate postoperatively to children who have undergone major surgery in preference to hypotonic fluids.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health</pub><pmid>22294668</pmid><doi>10.1136/archdischild-2011-300221</doi><tpages>6</tpages></addata></record> |
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| ispartof | Archives of disease in childhood, 2012-06, Vol.97 (6), p.491-496 |
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| language | eng |
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| source | MEDLINE; BMJ Journals - NESLi2 |
| subjects | Adolescent Back surgery Biological and medical sciences Brain Neoplasms - surgery Brain tumors Care and treatment Caregivers Case reports Child Child, Preschool Children & youth Complications Craniotomy Creatinine Electrolytes Female Fluid Therapy - methods Fluids General aspects Glucose - therapeutic use Hospitals Humans Hyponatremia Instrumentation Intensive care Intensive Care Units, Pediatric Intravenous therapy Isotonic Solutions - therapeutic use Laboratories Maintenance Male Medical sciences Medical Services Methods Miscellaneous Organic Chemistry Patient outcomes Patients Pediatrics Plasma Postoperative care Postoperative complications Postoperative Period Prevention Prevention and actions Prospective Studies Public health. Hygiene Public health. Hygiene-occupational medicine Sodium Sodium - blood Sodium Chloride - therapeutic use Spinal instrumentation Spine - surgery Surgery Urine |
| title | A randomised controlled trial of Hartmann's solution versus half normal saline in postoperative paediatric spinal instrumentation and craniotomy patients |
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