Çocuklarda Intraoperatif Sıvı Tedavisinin Postoperatif Elektrolit Seviyelerine Etkilerinin Retrospektif Değerlendirilmesi

Abstract

In children, if it is not given sufficient and suitable compositions of fluid, it will cause changes at volume and electrolyte in body compartments and it will increase the risk of morbidity and mortality. The purpose of perioperative crystalloid, colloid and blood transfusion is to replace the lost and to ensure the protection of adequate tissue perfusion and cardiovascular stability. The purpose of this study is to investigate the postoperative serum sodium, potassium, chloride and glucose value changes made by intraoperative parenteral fluid therapy. In this study ,we reviewed the files and anesthetic reports of the children between the age of 1 and 18 ages that are undergoing laparotomy longer than 1 hour, at Hacettepe University Hospital Pediatric Surgery department, from 2010 January to 2013 November retrospectively. The patients, that one or all of the blood sodium, potassium, chloride or glucose levels are not evaluated at preoperatively or the first 24 hours after surgery or both, are not considered in this study. Age (year), gender, body weight (kg) of patients, additional disease, type of surgery, duration of surgery, type of peroperative fluids that are used (SF, İsolyte-S®, SF+%5 Dextrose mixture, HES(130/0,4), Gelofusine, Fresh Frozen Plasma, Erythrocyte Suspension), preoperative and postoperative plasma sodium, potassium, chloride and glucose values are noted. 144 patients were enrolled in the study. All values of patients, including that preoperative and postoperative blood glucose and electrolytes, are statistically significant within the normal range except sodium levels of three patients. We found following results: İn intraoperative fluid management of children, the mixture of 100 ml SF and 20 ml % 5 dextrose does not change blood glucose levels and it can be used safely in patients at the risk of hypoglycaemia; usage of crystalloids with colloids and blood products when needed, do not change blood elektrolytes and glucose levels compared with preoperative values. It is recommended to release ready to use isotonic fluids including low concentration of dextrose, that do not cause hypo-hyperglycemia or hyponatremia, for intraoperative use at children in Turkey.