A novel balanced isotonic sodium solution vs normal saline during major surgery in children up to 36 months: a multicenter <scp>RCT</scp>

Disma, Nicola; Mameli, Leila; Pistorio, Angela; Davidson, Andrew; Barabino, Paola; Locatelli, Bruno Guido; Sonzogni, Valter; Montobbio, Giovanni

doi:10.1111/pan.12439

Cited by 45 publications

(30 citation statements)

References 21 publications

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“…Disma et al (16) found an increase in postinfusion sodium concentration in both NS and BF groups, but hypernatremia was not observed in the pediatric population. In summary, no significant different was found between both fluids, and prolonged infusion for over 24 h was not associated with hypernatremia.…”

Section: Discussionmentioning

confidence: 94%

Balanced Fluid Versus Saline-Based Fluid in Post-operative Severe Traumatic Brain Injury Patients: Acid-Base and Electrolytes Assessment

Hassan

Zaini

et al. 2017

MJMS

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Methods: Sixty-six severe TBI patients who required emergency craniotomy or craniectomy and were planned for post-operative ventilation were randomised into NS (n = 33) and BF therapy groups (n = 33). The calculation of maintenance fluid given was based on the Holliday-Segar method. The electrolytes and acid-base parameters were assessed at an 8 h interval for 24 h. The data were analysed using repeated measures ANOVA.Results: The NS group showed a significant lower base excess (-3.20 versus -1.35, P = 0.049), lower bicarbonate level (22.03 versus 23.48 mmol/L, P = 0.031), and more hyperchloremia (115.12 versus 111.74 mmol/L, P < 0.001) and hypokalemia (3.36 versus 3.70 mmol/L, P < 0.001) than the BF group at 24 h of therapy. The BF group showed a significantly higher level of calcium (1.97 versus 1.79 mmol/L, P = 0.003) and magnesium (0.94 versus 0.80 mmol/L, P < 0.001) than the NS group at 24 h of fluid therapy. No significant differences were found in pH, pCO 2 , lactate, and sodium level.Conclusion: BF therapy showed better effects in maintaining higher electrolyte parameters and reducing the trend toward hyperchloremic metabolic acidosis than the NS therapy during prolonged fluid therapy for postoperative TBI patients.

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Section: Discussionmentioning

confidence: 94%

Balanced Fluid Versus Saline-Based Fluid in Post-operative Severe Traumatic Brain Injury Patients: Acid-Base and Electrolytes Assessment

Hassan

Zaini

et al. 2017

MJMS

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“…[4243] Thus, the current guideline discourages the use of HES in patients with volume shock due to higher rates of mortality. [44454647]…”

Section: Discussionmentioning

confidence: 99%

Passive leg raising: Simple and reliable technique to prevent fluid overload in critically ill patients

Assadi

2017

Int J Prev Med

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Background:Dynamic measures, the response to stroke volume (SV) to fluid loading, have been used successfully to guide fluid management decisions in critically ill patients. However, application of dynamic measures is often inaccurate to predict fluid responsiveness in patients with arrhythmias, ventricular dysfunction or spontaneously breathing critically ill patients. Passive leg raising (PLR) is a simple bedside maneuver that may provide an accurate alternative to guide fluid resuscitation in hypovolemic critically ill patients.Methods:Pertinent medical literature for fluid responsiveness in the critically ill patient published in English was searched over the past three decades, and then the search was extended as linked citations indicated.Results:Thirty-three studies including observational studies, randomized control trials, systemic review, and meta-analysis studies evaluating fluid responsiveness in the critically ill patient met selection criteria.Conclusions:PLR coupled with real-time SV monitors is considered a simple, noninvasive, and accurate method to determine fluid responsiveness in critically ill patients with high sensitivity and specificity for a 10% increase in SV. The adverse effect of albumin on the mortality of head trauma patients and chloride-rich crystalloids on mortality and kidney function needs to be considered when choosing the type of fluid for resuscitation.

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“…Er wird in der Literatur kontrovers diskutiert [1,9,25,29] und bleibt ein spannendes Thema zukünftiger Forschung. Internationaler Standard ist eine plasmaisotone kristalloide Lösung, z.…”

Section: Auswahl Der Flüssigkeitunclassified

“…Internationaler Standard ist eine plasmaisotone kristalloide Lösung, z. B. glukosefreie Vollelektrolytlösungen (VEL) oder Kochsalzlösung (NaCl, 0,9 %; [9]). …”

Section: Auswahl Der Flüssigkeitunclassified

Schock im Kindesalter

Löllgen

Szabó

2015

Med Klin Intensivmed Notfmed

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The clinical signs and symptoms of shock in newborns and children are often more subtle compared to adults. Recurring, avoidable factors for optimal outcome include failure of health care workers to recognize shock at the time of presentation. Children are able to compensate a shock state for longer periods than adults resulting in a sudden, sometimes irreversible, cardiopulmonary collapse. Different forms of shock, their therapy, and frequent errors are depicted and illustrated with practical examples. Early recognition of shock in children is crucial for optimal outcome but is not always obvious. Clinical experience, gut feeling, and careful and repeated interpretation of the vital parameters are essential to recognize and effectively treat the various forms of shock.

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A novel balanced isotonic sodium solution vs normal saline during major surgery in children up to 36 months: a multicenter RCT

Abstract: Sterofundin is safer than normal saline in protecting young children undergoing major surgery against the risk of increasing plasma chlorides and the subsequent metabolic acidosis.

Cited by 45 publications

References 21 publications

Balanced Fluid Versus Saline-Based Fluid in Post-operative Severe Traumatic Brain Injury Patients: Acid-Base and Electrolytes Assessment

Balanced Fluid Versus Saline-Based Fluid in Post-operative Severe Traumatic Brain Injury Patients: Acid-Base and Electrolytes Assessment

Passive leg raising: Simple and reliable technique to prevent fluid overload in critically ill patients

Schock im Kindesalter

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