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Post-Operative Fluid Management

Dr Swapnil Pawar December 17, 2020 178


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    Post-Operative Fluid Management
    Dr Swapnil Pawar

Post-op Fluids

Written by Dr Hyerim Su

Daily requirements of electrolytes and water 

  • Water – 25mL/kg/day 
  • Sodium – 1.0mmol/kg/day 
  • Potassium – 1.0mmol/kg/day 
  • Glucose 50g/day 

Table 1. Composition of intravenous fluids

  • Dextrose is a hypotonic solution as the dextrose is metabolised, leaving only free water. Only 7% of the fluid stays in the intravascular component. 
  • 0.9% saline equilibrates in the intravascular and interstitial spaces, with 25% staying in the intravascular space. It is useful in resuscitation, but using it as the sole maintenance fluid can result in hyperchloremic acidosis. 
  • Hartmann’s is the most physiological fluid out of the three as it contains more electrolytes. A common misconception is that Hartmann’s causes lactic acidosis, but Hartmann’s solution contains lactate (the conjugate base), thus is actually an alkalising solution. 

 

References

https://teachmesurgery.com/perioperative/preoperative/intravenous-fluid-composition/

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