Liberal Versus Goal-directed Intraoperative Fluid Therapy in Pediatric Patients (GDT)
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Purpose
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.
| Condition | Intervention | Phase |
|---|---|---|
|
Adverse Anesthesia Outcome |
Drug: conventional liberal fluid regimen Drug: restricted fluid regimen |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Liberal VS Goal-directed Intraoperative Fluid Therapy in Pediatric Patients |
- Proportion of patients with 5% postoperative weight gain between control group and study group [ Time Frame: 24 hours ] [ Designated as safety issue: Yes ]Body weight
- Postoperative morbidity [ Time Frame: 4 days ] [ Designated as safety issue: Yes ]Postoperative morbidity: lung (new postoperative infiltration), prolonged ileus means inability to feed in postoperative day 4, kidney ( increase BUN, Cr), tissue hypoxia (wound infection, anastomotic leakage)
- Amount of intraoperative fluid [ Time Frame: 1 day ] [ Designated as safety issue: Yes ]Amount of intraoperative fluid
| Estimated Enrollment: | 40 |
| Study Start Date: | October 2011 |
| Estimated Study Completion Date: | September 2013 |
| Estimated Primary Completion Date: | June 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: control group
Control group will receive conventional liberal fluid regimen with crystalloid Liberal fluid regimen = Maintenance fluid + fasting fluid + dehydration + third space loss Maintenance fluid = (4X BW 1-10 kg) + (2X1BW11-20 kg) + (1X BW 0ver 21 kg) Fasting fluid = maintenance fluid X fasting duration
|
Drug: conventional liberal fluid regimen
Control group will receive conventional liberal fluid regimen with crystalloid Liberal fluid regimen = Maintenance fluid + fasting fluid + dehydration + third space loss Maintenance fluid = (4X BW 1-10 kg) + (2X1BW11-20 kg) + (1X BW 0ver 21 kg) Fasting fluid = maintenance fluid X fasting duration
Other Name: crystalloid
|
|
Experimental: study group
Study group will receive restricted fluid regimen (the same as control group except third space replacement) plus goal directed fluid therapy to maintain adequate CO guided by USCOM as shown in diagram (figure 1). Figure 1 goal directed fluid therapy SVV = Stroke volume variation SVI = Stroke volume index CI = Cardiac index |
Drug: restricted fluid regimen
Study group will receive restricted fluid regimen (the same as control group except third space replacement) plus goal directed fluid therapy to maintain adequate CO guided by USCOM as shown in diagram (figure 1). Figure 1 goal directed fluid therapy SVV = Stroke volume variation SVI = Stroke volume index CI = Cardiac index Other Name: crystalloid
|
Detailed Description:
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.
Eligibility| Ages Eligible for Study: | up to 5 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
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
Contacts and Locations| Contact: Suwannee Suraseranivongse, MD | 6681 4087655 | sisur@mahidol.ac.th |
| Contact: Suwannee Suraseranivongse | sisur2498@gmail.com |
| Thailand | |
| Siriraj Hospital | Active, not recruiting |
| Bangkok, Thailand, 10700 | |
| Principal Investigator: | Suwannee Suraseranivongse, MD | Mahidol University |
More Information
No publications provided
| Responsible Party: | Suwannee Suraseranivongse, Faculty of Medicine Siriraj Hospital, Mahidol University |
| ClinicalTrials.gov Identifier: | NCT01350076 History of Changes |
| Other Study ID Numbers: | Si 511/2010 |
| Study First Received: | March 30, 2011 |
| Last Updated: | May 6, 2011 |
| Health Authority: | Thailand: Ethical Committee |
Keywords provided by Mahidol University:
|
intraoperative fluid pediatric goal directed therapy pediatric with major abdominal surgery |
ASA less than or equal to 3 Duration of surgery less than 2 hours Body weight more than or equal to 15 kg |
ClinicalTrials.gov processed this record on May 19, 2013