The effect of usual versus limited fluid therapy in children undergoing abdominal, chest and genitourinary surgery.

Intervention1: Restricted fluid therapy: During intra-operative period, restricted fluid therapy group will receive maintenance and deficit correction as per Holliday-Segar formula and blood loss replacement (3:1 with Ringers lactate and 1:1 with blood according to anaesthesiologists decision). Fluid bolus will be given at 5ml/kg if stroke volume variation (SVV) in electrical cardiometry is more than 15% persistently for more than 5 min. At the end of surgery number of fluid boluses, serum lactate, sodium, potassium, calcium, blood urea and creatinine will be measured. Chest x ray will be taken in immediate post-operative period to look for signs of fluid overload. Assessment for nausea and vomiting will be done, weight will be checked if posssible. On post-operative day 2, blood urea and serum creatinine will be checked. Duration of hospital stay will be noted.
Control Intervention1: Standard fluid therapy: During intra-operative period, standard fluid therapy group will receive maintenance and deficit fluid correction as per Holliday-Segar formula, blood loss replacement and 3rd space loss replacement(4-7ml/kg for thoracotomy, 5-10ml/kg for abdominal surgery). Electrical cardiometry will be monitored in this group also. At the end of surgery number of fluid boluses, serum lactate, sodium, potassium, calcium, blood urea and creatinine will be measured. Chest x ray will be taken in immediate post-operative period to look for signs of fluid overload. Assessment for nausea and vomiting will be done, weight will be checked if posssible. On post-operative day 2, blood urea and serum creatinine will be checked. Duration of hospital stay will be noted.
Primary outcome(s): 1.Postoperative hypernatremia
2.Rise in serum lactate
3.Rise in blood urea
4.Rise in serum creatinine
Timepoint: At the end of surgery