None listed
Conditions
Brief summary
Literature and clinical experience have shown that children undergoing major spinal surgery or craniotomy are at particular risk of low sodium levels. The optimal management of fluid and electrolytes in this group of children has received much attention in the literature, but to date there is still no consensus on this matter. Although many studies have described post-operative hyponatraemia, there has not been to our knowledge a prospectively conducted randomised controlled trial of the post-operative use of hypotonic dextrose/saline (standard paediatric intravenous fluid therapy) versus isotonic saline therapy following major corrective spinal surgery or craniotomy to prevent hyponatraemia in a paediatric population. We will be conducting a randomised controlled trial of Hartmann's and 5% Dextrose compared with 0.45% Sodium Chloride and 5% Dextrose. We hypothesise that Hartman's and 5% Glucouse will minimise the postoperative fall in serum sodium following spinal surgery and craniotomy.
Interventions
Patients will be randomly allocated to Hartmann's and 5% Dextrose solution (experimental group). The rate of administration of fluids in the experimental group will be calculated at 100% of full paediatric fluid maintainence requirements. The intravenous fluids will be continued until eneteral feeding is recommenced (approximately 16 - 24hrs).
Sponsors
Study design
Eligibility
Inclusion criteria
* Patients who are admitted to the Paediatric Intensive Care Unit (PICU) (elective or emergency) following spinal fusion or craniotomy surgery. * Spinal fusion surgery includes posterior spinal instrumentation and fusion.* Craniotomy surgery includes excision of tumours and surgical correction of craniostenoses.
Exclusion criteria
* Parents/Guardians who are unable to read and write English.* Patients undergoing lengthening only of spinal growth rods, revision/insertion of ventriculoperitoneal (VP) shunts.