Comparing the Effectiveness of Intraoperative Fluid Therapy: Normal Saline Serum vs One-Fifth-Four-Fifth Serum on Biochemical Factors and Hemodynamic Parameters in Neonates

Intraoperative fluid therapy is to ensure adequate injection of maintenance fluids including electrolytes and glucose to replace fluid deficiency during surgery. Given that there is still no consensus on fluid therapy in neonates, the aim of this study was to evaluate the use of normal saline serum and one fifth-four fifths serum in neonates who are candidates for surgery. 

In a randomized clinical trial study, 72 neonates who were 1- 30-days-old and candidates for surgery, admitted to Imam Hossein Hospital in Isfahan were divided into two groups. Fluid therapy was randomly administered using normal saline or one-fifth-four-fifths fluid in each group. Biochemical and hemodynamic variables such as blood sugar, sodium, pH, bicarbonate BE, heart rate and mean arterial pressure were assessed preoperatively and postoperatively.

Post-operative blood glucose levels after 60-minutes at The Neonatal Intensive Care Unit (NICU) for the normal saline group were 152.56, 148.47 and 155.61 mg/dl, respectively, while in one fifth–four fifths solution group were 242.78, 197.28, 278.19 mg / dl, respectively, which showed a significant difference between the two types of solutions. There was also a significant increase in blood sugar compared to pre-operative states. Mean pre-operative plasma sodium levels showed a significant increase for the normal saline group and a significant decrease for the one fifth-four fifth group.

One fifth- four fifths solution owing to hyperglycemia and hyponatremia is not a suitable choice for intraoperative fluid therapy in neonates. In contrast, normal saline solution performed better in controlling blood sugar and plasma sodium.