Preoperative Fluid Therapy
Preoperative evaluation and correction of existing fluid disorders is an integral part of surgical care. An orderly approach to these problems requires an understanding of the common fluid...
View ArticleCorrection of Volume Changes
Changes in the volume of extracellular fluid are the most frequent and important abnormalities encountered in the surgical patient. Depletion of the extracellular fluid compartment without changes in...
View ArticleRate of Fluid Administration
The rate of fluid administration varies considerably, depending on the severity and type of fluid disturbance, the presence of continuing losses, and the cardiac status. The most severe volume...
View ArticleCorrection of Concentration Changes
If severe symptomatic hyponatremia or hypernatremia complicates the volume loss, prompt correction of the concentration abnormality to the extent that symptoms are relieved is necessary. Volume...
View ArticleComposition and Miscellaneous Considerations
Correction of existing potassium deficits should be started after an adequate urine output is obtained, particularly in the patient with metabolic alkalosis because this may be secondary to or...
View ArticleIntraoperative Fluid Management
If preoperative replacement of extracellular fluid volume has been incomplete, hypotension may develop promptly with the induction of anesthesia. This can be insidious because the ability of the awake...
View ArticlePostoperative Fluid Management
Immediate Postoperative Period Orders for postoperative fluids are not written until the patient is in the recovery room and the fluid status has been assessed. Evaluation at this point should include...
View ArticleLater Postoperative Period
The problem of volume management during the postoperative convalescent phase is one of accurate measurement and replacement of all losses. In the otherwise healthy individual, this involves the...
View ArticleSpecial Considerations in the Postoperative Patient Volume Excesses
The administration of isotonic salt solutions in excess of volume losses (external or internal) may result in overexpansion of the extracellular fluid space. The otherwise normal person in a...
View ArticleVolume Excess Hyponatremia
Significant postoperative alterations in serum sodium concentration are infrequent when the fluid resuscitation during operation has included adequate volumes of isotonic salt solutions. The kidneys...
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