CED 1 Perioperative Fluid Management

Normal saline: .9 %
normal saline (w/ or w/out dextrose 5%)
5% dextrose
10% Dextrose for person who is hypoglycemia
maintenance fluid therapy assumes normal sized adult w/ normal
kidneys and stable weight
- estimate her: 2 L day / 20 m kCl added to each liter = 83
ml/hour
** Dont use dextrose-containing fluids for variable rate IVs -> More
likely to become hyperglycemic (use non-dextrose containing IVs for
variable rates)
Replacement Fluid Therapy giving fluid thats been lost (so need
maintenance + replacement)
- Usual weight minus current weight gives best estimate of
deficit
- Urine will vary b/w < 10 or > 100 Na; K depends on what is
lost
Max conc. Of urine 1200 mOsm/kg
- daily osmotic load we have to get rid of 600 (from
breakdown of protein, etc.)
- Thus, minimum urine volume needed to excrete osmotic load
is:
o 600/1200 = 500 mL
Fluid resuscitation
- 30 ml/kg saline
- if fluid non responsive then pressors
- others are colloids, blood (if indicated), steroids (rare)
Sepsis during surgery
- Start w/ broad spectrum Ab and narrow when data in (obtain
blood cultures before starting Ab)
- To maintain fluid
o .9% NaCl w/ or w/out colloid If BP is still low after that
Go to pressors
Heart Disease/Heart Failure
-