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A Comparative Study of Peri-Operative Fluid Therapy With Ringer Lactate and PlasmaLyte in Children Undergoing
Andal Priyanka1, Usha Ganapathy1, Rajneesh Choudhary1
1Anesthesia and Critical Care, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND.
Insights
PlasmaLyte (PL) is a superior intravenous fluid for pediatric perioperative fluid therapy compared to Ringer's lactate (RL). PL demonstrated better acid-base balance and electrolyte profiles, avoiding hyponatremia and elevated lactate levels seen with RL.
Area of Science:
- Pediatric Anesthesiology
- Intravenous Fluid Therapy
- Critical Care Medicine
Background:
- Ringer's lactate (RL) is a commonly used intravenous fluid.
- PlasmaLyte (PL) is a newer alternative for fluid resuscitation.
- Perioperative fluid management in children requires careful consideration of fluid type.
Purpose of the Study:
- To compare the efficacy and safety of PlasmaLyte (PL) versus Ringer's lactate (RL) for perioperative fluid therapy in pediatric patients.
- To evaluate hemodynamic stability, acid-base status, serum electrolytes, and lactate levels.
- To determine the optimal IV fluid for pediatric abdominal surgeries.
Main Methods:
- Prospective, interventional, randomized comparative study.
- Inclusion of pediatric patients undergoing abdominal surgeries.
- Monitoring of hemodynamic parameters, acid-base status, electrolytes, and lactate levels.
Main Results:
- Hemodynamic parameters (SpO2, ETCO2, heart rate, blood pressure, temperature, urine output) remained stable in both groups.
- Children receiving PL exhibited improved acid-base status and serum electrolyte profiles.
- RL group experienced hyponatremia and increased postoperative blood lactate levels.
Conclusions:
- PlasmaLyte (PL) is a more beneficial fluid than Ringer's lactate (RL) for perioperative management in children.
- PL supports better metabolic and electrolyte balance during pediatric surgery.
- PL may reduce the risk of hyponatremia and elevated lactate in pediatric surgical patients.
Abstract:
Background In this study, we compared Ringer's lactate solution (RL) with PlasmaLyte (PL), a relatively new IV fluid, for perioperative fluid therapy in the pediatric population. Methods This prospective and interventional randomized comparative study was carried out after obtaining clearance from the Institutional Ethics Committee. The study period was from November 2016 to December 2017. Results Hemodynamic parameters such as SpO2, ETCO2, heart rate, blood pressure, temperature, and urine output were stable in both groups throughout the perioperative period without any statistically or clinically significant variations. Children receiving PL (group PL) had better acid-base status, serum electrolytes, and blood lactate profiles compared with children receiving RL (group RL), who had hyponatremia and increased blood lactate levels, which continued to increase in the immediate postoperative period. No significant differences in pH, pCO2, HCO3, serum potassium, serum chloride, blood urea, serum creatinine, or blood sugar were observed. Conclusions PL is better than RL for perioperative fluid therapy in children undergoing abdominal surgeries.
