Post op fluid replacement

nellie_nurse812 · Apr 16, 2009

there are many formulas out there for fluid replacement Your best resource would be to ask your anesthesia providers for their resources. It depends on type of surgery, blood loss, maintenance. A good rule of thumb for most healthy adults is that they could use 2L IVF's before discharge just to make up for NPO status.

nickola · Apr 27, 2009

there is some kind of a standard formula- if only I could remember it!! It has to do w/blood loss/npo status/pt weight & how much IVF needed to replace fluid loss from all those factors.............

metroishka · Apr 28, 2009

Three part formula for deriving amounts of fluid to be replaced:

A. Deficit is defined as the time the patient is NPO to the time surgery begins

1. 4 ml/kg/hr for the first 0-10 kg

2. 2 ml/kg/hr for the next 11-20 kg

3. 1 ml/kg/hr for weight greater than 21 kg

Maintenance is defined as the time of incision to closure (dependent on the type of surgical procedure)

1. Eye surgery, extremity procedure 5 ml/kg/hr

2. Mastectomy 8 ml/kg/hr

3. Minor abdominal procedure 8-10 ml/kg/hr

4. Laparotomy/resection, thorocotomy 12 ml/kg/hr

5. Extensive procedure 15-20 ml/kg/hr

C. Blood replacement: ml/ml for blood replacement plus 3 ml/ml crystalloid to estimated blood loss or 1 ml/ml of volume expander such as albumin

Schedule for replacement during the surgical procedure:

A. First hour: ½ the deficit + maintenance + blood replacement

B. Second hour: ¼ the deficit + maintenance + blood replacement

C. Third hour: ¼ the deficit + maintenance + blood replacement

REFERENCE

ASPAN, Redi-Ref 2004: Ambulatory/PACU/Pediatric (Ireland, D, Ed.). 10 Melrose Ave, Suite 110, Cherry Hill, NJ, p. 72, 2004.