Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACKGROUND:
A new formula (RY formula) for calculation of intra operative fluids given in neonatal & pediatric life threatening surgical operations was enrolled in this study.
OBJECTIVE:
To find a correct , simple ,easily applicable & understandable formula to avoid all unwanted dangerous mistakes in calculation of fluid requirements in all types of neonatal& pediatric surgical operations .
PATIENTS:
(Five Thousands Patients) including neonates , infants & pediatric age group presented to CWTH /Medical city /Baghdad for different types of surgical operations were enrolled in this study divided to 3 groups ( Group A ) Life threatening conditions 2300 patients , (Group B) Major& super major operations 700 patients &( Group C ) Different types of elective surgical operations 2000 patients .
METHODS:
In this new (RY formula) intra operative fluid requirements calculated as :
Pre existing deficit (Fasting) : 20 ml/kg this amount is divided over 3 hours : ½ the amount given in the 1st hour of operation , and ¼ the amount is given for each the 2nd& 3rd hours of operations. Maintenance fluid requirements : 4 ml/kg/hr for all weights. 3rd Space replacement : 8 ml/kg/hr for major& super major operations & 4 ml/kg/hr for minor operations .
RESULTS :
By comparison of this new (RY formula) with most of other anesthesia text books fluid formulas and anesthetic references regarding this aspects the results is that the difference in the amounts of fluid requirements was minute and regarded as negligible difference .
CONCLUSION:
This new formula has been used for the last six years(2005-2010) in neonatal & pediatric anesthetic department in CWTH/ Baghdad Medical City complex for 5000 neonates ,infants & pediatric patients without any complications.This new formula is correct, simpler, safer ,easily applicable understandable than other formulas. The most important point in this new(RY formula) is that it can be summarized by just 2 numbers( 22- 17)
22 ml/kg for the 1st hour & 17 ml for the 2nd&3rd hour of operation for major operations.