Perioperative fluid therapy in pediatrics

Murat, I.; Dubois, Marie‐Claude

doi:10.1111/j.1460-9592.2008.02505.x

Cited by 86 publications

(56 citation statements)

References 66 publications

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“…In our experience, we suggest to perform contrast enema during pre-operative assessment to evaluate and to rule out associated pathologies of the large bowel and malrotation disorders, which can be unnoticed with STL approach. [10] When these conditions are ruled out, STL procedure could be safely performed. STL procedure total of 59 newborns [3][4][5][6][7] [ Table 2].…”

Section: Resultsmentioning

confidence: 99%

“…In fact, the minor bowel exposure leads to lower third-space losses than in classical incision. [10] Concerning the aesthetical aspects, the presence of a permanent large scar remains a concerns for caregivers and children, [3] and STL incision leads to a virtually invisible scar within few months. [1,7,11] Suri and colleagues [6] reported a higher incidence of incisional hernia in circumumbilical incision group compared to transverse laparotomic one (38% vs. 6%).…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Supra-transumbilical laparotomy (STL) approach for small bowel atresia repair: Our experience and review of the literature

Leva

Parolini

Zanini

et al. 2013

Afr J Paediatr Surg

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Supra-transumbilical laparotomy (STL) approach for small bowel atresia repair: Our experience and review of the literature

Leva

Parolini

Zanini

et al. 2013

Afr J Paediatr Surg

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“…However, research has shown that normal healthy infants can withstand prolonged fasting and it may not be necessary to administer preoperative glucose or to even monitor glucose in these patients 31. In 2012, a NICE-SUGAR follow-up trial identified a significant relationship between hypoglycemia and mortality, but could not prove causality 32.…”

Section: Pediatric Glycemiamentioning

confidence: 99%

“…To counteract this, it became widely accepted practice to administer dextrose, which led to hyperglycemia 3. During surgery, fluid replacement aims to provide basal energy requirements and compensates any fasting deficit; unfortunately, Murat and DuBois believe that guidelines are not always applicable or followed 31. This suggests that routine intraoperative solution use should potentially be re-evaluated in terms of secondary post-surgical outcomes 31…”

Section: Treating Hypoglycemiamentioning

confidence: 99%

Does tight glycemic control improve outcomes in pediatric patients undergoing surgery and/or those with critical illness?

Forbes¹,

Anders²

2013

IJGM

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This literature review examines the current evidence regarding the potential usefulness of tight glycemic control in pediatric surgical patients. In adults, fluctuations in glucose levels and/or prolonged hyperglycemia have been shown to be associated with poor outcomes with respect to morbidity and mortality. This review begins by summarizing the findings of key papers in adult patients and continues by investigating whether or not similar results have been seen in pediatric patients by performing a comprehensive literature review using Medline (OVID). A database search using the OVID interface and including the search terms (exp glucose) AND (exp surgery) AND (exp Paediatric/pediatric) AND (exp Hypoglycaemia/hypoglycemia) AND (exp Hyperglycaemia/hyperglycemia) yielded a total of 150+ papers, of which 24 fulfilled our criteria. We isolated papers utilizing pediatric patients who were hospitalized due to illness and/or surgery. Our review highlights several difficulties encountered in addressing this potentially useful clinical intervention. An absence of scientifically robust and randomized trials and the existence of several small-powered trials yielding conflicting results mean we cannot recommend tight glycemic control in these patients. Differences in study design and disagreements concerning the crucial stage of surgery where hyperglycemia becomes important are compounded by an over-reliance on the discretion of clinicians in the absence of well described treatment protocols. Closer inspection of key papers in adult patients identified fundamental discrepancies between exact definitions of both hyperglycemia and hypoglycemia. This lack of consensus, along with a fear of inducing iatrogenic hypoglycemia in pediatric patients, has resulted in professional bodies advising against this form of intervention. In conclusion, we cannot recommend use of tight glycemic control in pediatric surgical patients due to unclear glucose definitions, unclear thresholds for treatment, and the unknown long-term effects of iatrogenic hypoglycemia on the developing body and brain.

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“…[4] But, hyperglycemia causes osmotic diuresis, dehydration and electrolye imbalance. The danger of hyperglycemia in the perioperative period is a real clinical issue that has been extensively reviewed.…”

mentioning

confidence: 99%