{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T02:00:04Z","timestamp":1783476004104,"version":"3.55.0"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,2,13]],"date-time":"2024-02-13T00:00:00Z","timestamp":1707782400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Intraoperative fluid therapy maintains normovolemia, normal tissue perfusion, normal metabolic function, normal electrolytes, and acid\u2013base status. Plethysmographic variability index has been shown to predict fluid responsiveness but its role in guiding intraoperative fluid therapy is still elusive.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>The aim of the present study was to compare intraoperative goal\u2010directed fluid therapy based on plethysmographic variability index with liberal fluid therapy in term neonates undergoing abdominal surgeries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective randomized controlled study was conducted in a tertiary care centre, over a period of 18\u2009months. A total of 30 neonates completed the study out of 132 neonates screened. Neonates with tracheoesophageal fistula, congenital diaphragmatic hernia, congenital heart disease, respiratory disorders, creatinine clearance &lt;90\u2009mL\/min and who were hemodynamically unstable were excluded. Neonates were randomized to goal\u2010directed fluid therapy group where the plethysmographic variability index was targeted at &lt;18 or liberal fluid therapy group. Primary outcome was comparison of total amount of fluid infused intraoperatively in both the groups. Secondary outcomes included intraoperative and postoperative arterial blood gas parameters, biochemical parameters, use of vasopressors, number of fluid boluses, complications and duration of hospital stay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was no significant difference in total intraoperative fluid infused [90 (84\u2013117.5\u2009mL) in goal\u2010directed fluid therapy and 105 (85.5\u2013144.5\u2009mL) in liberal fluid therapy group (<jats:italic>p<\/jats:italic>\u2009=\u2009.406)], median difference (95% CI) \u221215 (\u221249.1 to 19.1). There was a decrease in serum lactate levels in both groups from preoperative to postoperative 24\u2009h. The amount of fluid infused before dopamine administration was significantly higher in liberal fluid therapy group (58 [50.25\u201365\u2009mL]) compared to goal\u2010directed fluid therapy group (36 [22\u201344\u2009mL], <jats:italic>p<\/jats:italic>\u2009=\u2009.008), median difference (95% CI) \u221222 (\u221246 to 2). In postoperative period, the total amount of fluid intake over 24\u2009h was comparable in two groups (222 [204\u2013253\u2009mL] in goal\u2010directed fluid therapy group and 224 [179.5\u2013289.5\u2009mL] in liberal fluid therapy group, <jats:italic>p<\/jats:italic>\u2009=\u2009.917) median difference (95% CI) cutoff \u22122 (\u221265.3 to 61.2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Intraoperative plethysmographic variability index\u2010guided goal\u2010directed fluid therapy was comparable to liberal fluid therapy in terms of total volume of fluid infused in neonates during perioperative period. More randomized controlled trials with higher sample size are required.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p>Central Trial Registry of India (CTRI\/2020\/02\/023561).<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.14856","type":"journal-article","created":{"date-parts":[[2024,2,13]],"date-time":"2024-02-13T11:45:17Z","timestamp":1707824717000},"page":"559-567","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Goal\u2010directed fluid therapy guided by plethysmographic variability index versus conventional liberal fluid therapy in neonates undergoing abdominal surgery: A prospective randomized controlled trial"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9285-581X","authenticated-orcid":false,"given":"A. S.","family":"Swathy","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Intensive Care All India Institute of Medical Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3772-366X","authenticated-orcid":false,"given":"Anudeep","family":"Jafra","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Post Graduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neerja","family":"Bhardwaj","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Post Graduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi P.","family":"Kanojia","sequence":"additional","affiliation":[{"name":"Department of Pediatric surgery Post Graduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Bawa","sequence":"additional","affiliation":[{"name":"Department of Pediatric surgery Post Graduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,13]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.19.5.823"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000094387.50865.23"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-016-1393-6"},{"key":"e_1_2_11_5_1","first-page":"123","article-title":"Functional hemodynamic monitoring and dynamic indices of fluid responsiveness","volume":"74","author":"Cavallaro F","year":"2008","journal-title":"Minerva 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