A Comparison of Sterofundin and Ringer’s Lactate on Intraoperative Acid Base and Electrolytes Status in Children: A Randomized Controlled Trial

Background: Perioperative fluid management of pediatric patients is very challenging, as children are unable to cope with inappropriate water and electrolyte administration. Suboptimal fluid management leads to deleterious effects on cardiovascular stability and alte red tissue perfusion. We evaluate the Intraoperative use of Sterofundin  as the main crystalloid in moderate to major pediatric surgery in comparison to Ringer's lactate. The primary outcome was the changes of plasma pH from the start of surgery to the end of surgery. The secondary outcomes included changes of Intraoperative plasma electrolyte and Intraoperative hyper/hypoglycemia. Methodology: A total of 30 children aged between 1 - 13 years old, were enrolled and randomized into two arms, to receive Sterofun din or Ringer's Lactate intraoperatively. Children with renal, cardiac or liver dysfunction, hypervolemia states, electrolyte imbalance and metabolic acidosis were excluded. Acid - base status, electrolyte balance and hemodynamic variables were recorded at b aseline and repeated every hour until one hour postoperatively. Results: In Ringer's Lactate group, the mean difference in pH between the baseline and end of surgery was 0.07  0.06 (p=0.001, 95% CI 0.03 - 0.09) and in Sterofundin group the mean difference in pH was 0.05  0.06 (p=0.010, 95% CI 0.01 - 0.08). For base excess (BE), the mean difference in BE between the baseline and end of surgery was - 1.664  2.694(p=0.035) in Ringer's Lactate group while in Sterofundin group the mean difference in BE is - 1.331  3.327(p =0.175). Conclusion: The use of Sterofundin is better to Ringer's Lactate in the management of Intraoperative acid base, electrolyte and hemodynamic parameters in pediatric patient undergoing major surgery