Perioperative fluid therapy and intraoperative blood loss in children

Bhardwaj, Neerja

doi:10.4103/ija.ija_493_19

Cited by 13 publications

(30 citation statements)

References 44 publications

(55 reference statements)

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“…Similar results were also found, as significantly lower requirement of fluid and fewer complications in the FloTrac group[ 17 18 ] or in the TED group[ 19 20 21 22 ] as compared to CVP (conventional) group in RT. Other studies have also proven that dynamic indices of haemodynamic monitoring reduce postoperative complications and hospital stay, short and long-term morbidity and mortality in various high-risk surgical patients.…”

Section: Discussionsupporting

confidence: 73%

“…[ 14 15 ] These newer techniques along with adequate haemodynamic optimisation in various high-risk surgeries including transplantation had improved the early recovery and significantly reduced the postoperative complications. [ 16 17 ] In renal transplant recipients, even CFT (TED) guided fluid therapy had proven better outcomes to CVP with lesser side effects. Recent studies have proven that both TED or FloTrac can be used as individualised GDFT in renal transplantation safely but no RCT has compared both the techniques as was done in this study.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

To compare intraoperative goal directed fluid therapy by trans-oesophageal Doppler vis-à-vis FloTrac™ in patients undergoing living related renal transplantation-a prospective randomised controlled study

Kaur¹,

Sahu²,

Srivastava³

et al. 2020

Indian J Anaesth

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Background: Optimal intra-operative fluid therapy in renal transplantation (RT) is essential to ensure adequate graft function while preventing fluid overload related complications. This RCT was to compare the intraoperative goal directed fluid therapy (GDFT) based either on corrected flow time (CFT), measured by trans oesophageal Doppler (TED) or on the stroke volume variation (SVV), by FloTrac in patients undergoing living donor RT. Methods: This prospective, randomised controlled trial (RCT) was done on 60 end stage renal disease (ESRD) patients, American Society of Anaesthesiologists(ASA) grade III–IV, age 18 to 65 years of either sex, scheduled for living donor RT under general anaesthesia. They were randomly divided into two groups: TED group ( n = 30) and FloTrac™ group ( n = 30) and administered GDFT, based upon CFT (TED) and SVV (FloTrac™). The primary outcome was to compare the total fluid and number of fluid boluses administered intraoperatively, while the secondary outcomes were to compare any postoperative complications due to fluid overload and allograft function, assessed by serial serum creatinine levels up to 90 days postoperatively. Results: The mean total intra-operative fluid [3991.67 ± 856.32 vs. 3543.33 ± 1131.35, P = 0.089] and the amount of fluid administered per kg body weight per hour [13.32 ± 4.67 vs. 11.82 ± 4.76, P = 0.222] were lesser in the FloTrac compared to TED group, though not statistically significant. However, the postoperative incidence of allograft dysfunction, including rejection ( P = 0.743) and acute tubular necrosis (ATN) ( P = 0.999), and other complications ( P = 0.643) were comparable. Conclusions: Both TED and FloTrac devices can be used effectively to guide GDFT in RT, However, lesser total fluid was required in the FloTrac group, which may lead to a lesser number of fluid-related postoperative complications.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

To compare intraoperative goal directed fluid therapy by trans-oesophageal Doppler vis-à-vis FloTrac™ in patients undergoing living related renal transplantation-a prospective randomised controlled study

Kaur¹,

Sahu²,

Srivastava³

et al. 2020

Indian J Anaesth

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“…The Intracellular fluid accounts for two-thirds of body water[ 4 ] and around 24 weeks gestation, close 80% of total body weight of the fetus is made up of water, which reduces to around 60% at the age of one year of age and in adults it is between 50% and 60%. [ 2 ]…”

Section: Introductionmentioning

confidence: 99%

“…Physiologically the amount of fluid filtering outward from the arterial ends of the capillaries equals almost exactly the fluid returned to the circulation by absorption. [ 4 ]…”

Section: Introductionmentioning

confidence: 99%

Pediatric perioperative fluid management

Mathew

Rai

2021

Saudi J Anaesth

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Appropriate fluid management is vital for adequate tissue perfusion and balancing the internal milieu especially in perioperative settings and critically ill children. Pediatric population is heterogeneous so one formula may not suffice and hence both the quantitative and qualitative perspective of fluid management should be based on physiology and pathology of the child along with their perioperative needs. In perioperative setup, the fluid is administered to meet fluid deficits (fasting, and other daily based losses), blood losses and third space losses. Anesthetists have always followed pediatric maintenance fluid calculations based on Holiday and Segar formula; based on studies conducted on healthy children more than 70 years ago. Recently, there has been a lot of debate about this concept, especially as there are serious concerns regarding the development of complications like hyponatremia and hyperglycemia, both of which can result in neurological damage or even mortality in a sick child. This review is an attempt to provide a historical perspective and current evidence-based approach to peri-operative pediatric fluid management. We performed a PUBMED search for articles using keywords including ‘children’, ‘intravenous fluid therapy’, ‘crystalloids’, ‘colloids’, ‘fluid homeostasis’, ‘blood loss’, ‘estimation of blood loss’, ‘blood loss management’, ‘perioperative fluid ‘ to get our source articles.

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“…Paediatric patients undergoing surgery necessitate intravenous (IV) fluid administration to compensate perioperative deficits, third-space losses and haemorrhage. [ 1 ] One of the necessary components of perioperative monitoring for paediatric surgery of prolonged duration is hourly urine output measurement. Urine measurement via urinary catheter can be used as an indirect marker of renal, cardiovascular and fluid status of the patient.…”

mentioning

confidence: 99%