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 with blood products for Fluid Replacement Therapy for some of the indication

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

blood products
Albumin

Fluid replacement

Physiological saline
Dextrose/saline
5 % albumin
Plasma electrolyte
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

Fluid Replacement Therapy

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

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

Management of Blood loss to estimate and corrected by the following methods

Fluid replacement

Manage with whole Blood and other products

Using the Cell saver machine in intraoperative Surgical procedures with a high risk.

see here for Ventilator 

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