Liberal Versus Goal-directed Intraoperative Fluid Therapy in Pediatric Patients

Liberal VS Goal-directed Intraoperative Fluid Therapy in Pediatric Patients

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.

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.

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