Fluid needs should be assessed before, during and after major surgeries. Replacement fluids should be as suitable as possible in size and composition with lost fluids.
Blood transfusion is essential to restore oxygen carrying capacity when more than 15% of rotary blood volume is lost but must be avoided when the presence of HIV and hepatitis B virus is not feasible.
Sodium chloride solution can be used as an equalizer for short term volumetric substitution. Plasma plaques such as 70 dextran or polyglycerine may be useful. Liquid can be replaced by the simplest form by giving intravenous sodium chloride solution (NaCl 9 mg, 0.9%) or the most suitable physico-lactate solution, provided that kidney function is maintained. In emergencies, there is always a lack of fluid, which should be evaluated and corrected before surgery. Glucose and sodium chloride mixtures equal to stress (mostly 4% glucose and sodium chloride 0.18%) are preferred in the case of children to avoid the risk of increased sodium load and hypoglycemia. When fluids are given intravenously for more than 24 hours, potassium chloride should be given to prevent potassium depletion. To avoid serious arrhythmias, especially in patients with renal dysfunction, the potassium dose should be determined, whenever possible, to monitor potassium concentrations in the plasma.
Blood transfusion is essential to restore oxygen carrying capacity when more than 15% of rotary blood volume is lost but must be avoided when the presence of HIV and hepatitis B virus is not feasible.
Sodium chloride solution can be used as an equalizer for short term volumetric substitution. Plasma plaques such as 70 dextran or polyglycerine may be useful. Liquid can be replaced by the simplest form by giving intravenous sodium chloride solution (NaCl 9 mg, 0.9%) or the most suitable physico-lactate solution, provided that kidney function is maintained. In emergencies, there is always a lack of fluid, which should be evaluated and corrected before surgery. Glucose and sodium chloride mixtures equal to stress (mostly 4% glucose and sodium chloride 0.18%) are preferred in the case of children to avoid the risk of increased sodium load and hypoglycemia. When fluids are given intravenously for more than 24 hours, potassium chloride should be given to prevent potassium depletion. To avoid serious arrhythmias, especially in patients with renal dysfunction, the potassium dose should be determined, whenever possible, to monitor potassium concentrations in the plasma.
Labels
Anesthesia