Fluid Replacement in Craniofacial Pediatric Surgery
Bibliographic record
Abstract
INTRODUCTION: Pediatric craniofacial surgery requires large amounts of intravenous fluid replacement that may alter the ionic composition of body compartments. Normal (0.9%) saline (NS) and Ringer's lactate (RL) solutions are commonly used, with different advantages and disadvantages. Our hypothesis was that there would be more acidosis with NS but with no advantage of NS over RL regarding the incidence of hyponatremia. Our objective was to determine whether acid-base and electrolyte outcomes could guide fluid management in this group of patients. METHODS: A retrospective study of 122 children younger than 5 years who underwent craniofacial surgery was performed: 63 received only NS (NS group) and 59 received RL (RL group). Blood gases, plasma sodium, and potassium concentrations were analyzed during 2 different periods: 1 to 2 hours from anesthetic induction (P-1) and 2 to 4 hours from anesthetic induction (P-2). Statistical comparisons were made with χ test and t-test, as appropriate. RESULTS: Acidosis was more frequent in NS group than in RL patients during P-1 and P-2: 66% and 80% in the NS group versus 26% and 37% in the RL group. Severe acidosis (pH ≤ 7.25) was also more frequently in those receiving NS (39%) than RL (8%); and so was a base excess of -5 or less: NS = 53% and RL = 16%. The incidence of hyponatremia (Na < 135 mmol/L) was similar in both groups: 40% (NS) and 26% (RL) during P-1 and 52% (NS) and 50% (RL) during P-2. CONCLUSIONS: In young children undergoing craniofacial surgery, RL may be a preferred crystalloid over NS because metabolic acidosis is less frequent, with no increased incidence of hyponatremia.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".