Fluid management in Surgical practices

Fluid management indicated in a condition like dehydration: preoperative fasting, abnormal loss of fluid as in vomiting, Burns
Blood loss

Body Temperature
Maintenance of fluid management and requirements

Fluid Loss

5 % loss of the fluid: dry tongue and mouth change in color of the tongue into pale blue like appearance
10 % loss of fluid dry tongue lethargic child skin flaccid fontanelle sunken, tachypnea, tachycardia, low blood pressure, urine output diminished
15 % loss of the fluid child not responsive dry tongue loose skin fontanelle sunken thready pulse severe hypotension oliguria respiratory distress rise of body temperature

Laboratory studies

Hb %
hematocrit
electrolytes
urea creatinine
the osmolality of urine and blood
fluid replacement
physiological saline
dextrose/saline
5 % albumin
Plasma electrolyte
blood and blood products

Maintenance of fluid requirement

First 10 kg body weight 4 ml/kg/hr

Second 10 kg body weight 2 ml/kg/hr

Excess of 20 kg 1 ml/kg/hr

Blood loss – Fluid Replacement Therapy

More than 10% of the estimated blood volume loss results in blood replacement with milliliter for milliliter.

Replacement with crystalloid solution volume is calculated 3 to 4 times of blood loss

Management of Blood loss

Management of blood loss estimated and corrected by the following methods

Fluid replacement

Manage with whole Blood and blood products

Using the Cell saver machine in intraoperative Surgical procedures with a risk of blood loss.

 

 

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