Effects of a restrictive fluid regimen in pediatric patients undergoing major abdominal surgery
Summary 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...
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| Veröffentlicht in: | Pediatric anesthesia 2015-05, Vol.25 (5), p.530-537 |
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| container_title | Pediatric anesthesia |
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| creator | Mandee, Sahatsa Butmangkun, Wassana Aroonpruksakul, Naiyana Tantemsapya, Niramol von Bormann, Benno Suraseranivongse, Suwannee |
| description | Summary
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 |
| doi_str_mv | 10.1111/pan.12589 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1672089152</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3646564131</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4619-9e8351c83c032d878b615bad64d0f7539e087f818d367a3023adc3a04fe599893</originalsourceid><addsrcrecordid>eNp1kElPHDEQhS2UCAjhwB-ILOVCDg1e2tsRsQUxIjkkipSL5WmXR570ht2dMP8-hgEOkVKXKrm-91R-CB1RckJLnY6uP6FMaLOD9mktSWWEYW_KTIWohKzFHnqX85oQyplku2iPidoIQcQ-spchQDNlPATscII8pdhM8Tfg0M7Rl5dV7KDHsccj-Oge13h0U4S-iObeQ1oNsV_hzq2HhN3SD13sXYvznFaQNu_R2-DaDIfP_QB9v7r8dv65Wny5vjk_W1RNLampDGguaKN5QzjzWumlpGLpvKw9CUpwA0SroKn2XCrHCePON9yROoAwRht-gI63vmMa7ufyDdvF3EDbuh6GOVsqFSPaUMEK-vEfdD3Mqdz8RBFiVM14oT5tqSYNOScIdkyxc2ljKbGPqduSun1KvbAfnh3nZQf-lXyJuQCnW-BPbGHzfyf79ezuxbLaKmKe4OFV4dIvKxVXwv64u7aS3vKfZKHsBf8LsWGaCg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1670097423</pqid></control><display><type>article</type><title>Effects of a restrictive fluid regimen in pediatric patients undergoing major abdominal surgery</title><source>MEDLINE</source><source>Wiley Online Library All Journals</source><creator>Mandee, Sahatsa ; Butmangkun, Wassana ; Aroonpruksakul, Naiyana ; Tantemsapya, Niramol ; von Bormann, Benno ; Suraseranivongse, Suwannee</creator><contributor>Anderson, Brian ; Anderson, Brian</contributor><creatorcontrib>Mandee, Sahatsa ; Butmangkun, Wassana ; Aroonpruksakul, Naiyana ; Tantemsapya, Niramol ; von Bormann, Benno ; Suraseranivongse, Suwannee ; Anderson, Brian ; Anderson, Brian</creatorcontrib><description>Summary
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.</description><identifier>ISSN: 1155-5645</identifier><identifier>EISSN: 1460-9592</identifier><identifier>DOI: 10.1111/pan.12589</identifier><identifier>PMID: 25495505</identifier><language>eng</language><publisher>France: Blackwell Publishing Ltd</publisher><subject>Abdomen - surgery ; Body Weight ; Child ; Child, Preschool ; Female ; fluid management ; Fluid Therapy - methods ; Fluid Therapy - statistics & numerical data ; goal directed ; Hemodynamics ; Humans ; Infant ; Infant, Newborn ; interstitial space replacement ; Male ; pediatric ; Perioperative Care - methods ; Perioperative Care - statistics & numerical data ; Postoperative Complications - epidemiology ; Water-Electrolyte Balance</subject><ispartof>Pediatric anesthesia, 2015-05, Vol.25 (5), p.530-537</ispartof><rights>2014 John Wiley & Sons Ltd</rights><rights>2014 John Wiley & Sons Ltd.</rights><rights>Copyright © 2015 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4619-9e8351c83c032d878b615bad64d0f7539e087f818d367a3023adc3a04fe599893</citedby><cites>FETCH-LOGICAL-c4619-9e8351c83c032d878b615bad64d0f7539e087f818d367a3023adc3a04fe599893</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fpan.12589$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fpan.12589$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25495505$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Anderson, Brian</contributor><contributor>Anderson, Brian</contributor><creatorcontrib>Mandee, Sahatsa</creatorcontrib><creatorcontrib>Butmangkun, Wassana</creatorcontrib><creatorcontrib>Aroonpruksakul, Naiyana</creatorcontrib><creatorcontrib>Tantemsapya, Niramol</creatorcontrib><creatorcontrib>von Bormann, Benno</creatorcontrib><creatorcontrib>Suraseranivongse, Suwannee</creatorcontrib><title>Effects of a restrictive fluid regimen in pediatric patients undergoing major abdominal surgery</title><title>Pediatric anesthesia</title><addtitle>Paediatr Anaesth</addtitle><description>Summary
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.</description><subject>Abdomen - surgery</subject><subject>Body Weight</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>fluid management</subject><subject>Fluid Therapy - methods</subject><subject>Fluid Therapy - statistics & numerical data</subject><subject>goal directed</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>interstitial space replacement</subject><subject>Male</subject><subject>pediatric</subject><subject>Perioperative Care - methods</subject><subject>Perioperative Care - statistics & numerical data</subject><subject>Postoperative Complications - epidemiology</subject><subject>Water-Electrolyte Balance</subject><issn>1155-5645</issn><issn>1460-9592</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kElPHDEQhS2UCAjhwB-ILOVCDg1e2tsRsQUxIjkkipSL5WmXR570ht2dMP8-hgEOkVKXKrm-91R-CB1RckJLnY6uP6FMaLOD9mktSWWEYW_KTIWohKzFHnqX85oQyplku2iPidoIQcQ-spchQDNlPATscII8pdhM8Tfg0M7Rl5dV7KDHsccj-Oge13h0U4S-iObeQ1oNsV_hzq2HhN3SD13sXYvznFaQNu_R2-DaDIfP_QB9v7r8dv65Wny5vjk_W1RNLampDGguaKN5QzjzWumlpGLpvKw9CUpwA0SroKn2XCrHCePON9yROoAwRht-gI63vmMa7ufyDdvF3EDbuh6GOVsqFSPaUMEK-vEfdD3Mqdz8RBFiVM14oT5tqSYNOScIdkyxc2ljKbGPqduSun1KvbAfnh3nZQf-lXyJuQCnW-BPbGHzfyf79ezuxbLaKmKe4OFV4dIvKxVXwv64u7aS3vKfZKHsBf8LsWGaCg</recordid><startdate>201505</startdate><enddate>201505</enddate><creator>Mandee, Sahatsa</creator><creator>Butmangkun, Wassana</creator><creator>Aroonpruksakul, Naiyana</creator><creator>Tantemsapya, Niramol</creator><creator>von Bormann, Benno</creator><creator>Suraseranivongse, Suwannee</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</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>K9.</scope><scope>7X8</scope></search><sort><creationdate>201505</creationdate><title>Effects of a restrictive fluid regimen in pediatric patients undergoing major abdominal surgery</title><author>Mandee, Sahatsa ; Butmangkun, Wassana ; Aroonpruksakul, Naiyana ; Tantemsapya, Niramol ; von Bormann, Benno ; Suraseranivongse, Suwannee</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4619-9e8351c83c032d878b615bad64d0f7539e087f818d367a3023adc3a04fe599893</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Abdomen - surgery</topic><topic>Body Weight</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>fluid management</topic><topic>Fluid Therapy - methods</topic><topic>Fluid Therapy - statistics & numerical data</topic><topic>goal directed</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>interstitial space replacement</topic><topic>Male</topic><topic>pediatric</topic><topic>Perioperative Care - methods</topic><topic>Perioperative Care - statistics & numerical data</topic><topic>Postoperative Complications - epidemiology</topic><topic>Water-Electrolyte Balance</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mandee, Sahatsa</creatorcontrib><creatorcontrib>Butmangkun, Wassana</creatorcontrib><creatorcontrib>Aroonpruksakul, Naiyana</creatorcontrib><creatorcontrib>Tantemsapya, Niramol</creatorcontrib><creatorcontrib>von Bormann, Benno</creatorcontrib><creatorcontrib>Suraseranivongse, Suwannee</creatorcontrib><collection>Istex</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 Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mandee, Sahatsa</au><au>Butmangkun, Wassana</au><au>Aroonpruksakul, Naiyana</au><au>Tantemsapya, Niramol</au><au>von Bormann, Benno</au><au>Suraseranivongse, Suwannee</au><au>Anderson, Brian</au><au>Anderson, Brian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of a restrictive fluid regimen in pediatric patients undergoing major abdominal surgery</atitle><jtitle>Pediatric anesthesia</jtitle><addtitle>Paediatr Anaesth</addtitle><date>2015-05</date><risdate>2015</risdate><volume>25</volume><issue>5</issue><spage>530</spage><epage>537</epage><pages>530-537</pages><issn>1155-5645</issn><eissn>1460-9592</eissn><abstract>Summary
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.</abstract><cop>France</cop><pub>Blackwell Publishing Ltd</pub><pmid>25495505</pmid><doi>10.1111/pan.12589</doi><tpages>8</tpages></addata></record> |
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| ispartof | Pediatric anesthesia, 2015-05, Vol.25 (5), p.530-537 |
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| source | MEDLINE; Wiley Online Library All Journals |
| subjects | Abdomen - surgery Body Weight Child Child, Preschool Female fluid management Fluid Therapy - methods Fluid Therapy - statistics & numerical data goal directed Hemodynamics Humans Infant Infant, Newborn interstitial space replacement Male pediatric Perioperative Care - methods Perioperative Care - statistics & numerical data Postoperative Complications - epidemiology Water-Electrolyte Balance |
| title | Effects of a restrictive fluid regimen in pediatric patients undergoing major abdominal surgery |
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