Intraoperative_Fluid_Dosing_Adult_Patients v.1

Intraoperative Fluid Dosing in Adult Patients doses IV fluids intraoperatively.

Therese Lindberg

therese.lindberg@cambio.se

@CambioCDS

To calculate IV fluids intraoperatively.

Use in patients undergoing surgery who weigh ≥20 kg and do not have conditions that could otherwise result in fluid overload such as heart failure, COPD, or kidney failure on dialysis. Formula: Hourly maintenance fluid, mL/hr = body weight, kg + 40 mL NPO fluid deficit, mL = hourly maintenance fluid, mL/hr × time spent NPO, hrs 1st hour fluids: ½ NPO fluid deficit + hourly maintenance fluid 2nd hour fluids: ¼ NPO fluid deficit + hourly maintenance fluid + fluid loss from surgical trauma* 3rd hour fluids: ¼ NPO fluid deficit + hourly maintenance fluid + fluid loss from surgical trauma* 4th hour fluids and beyond: hourly maintenance fluid + fluid loss from surgical trauma* *Estimated fluid loss from surgical trauma: Minimal (e.g. hernia repair, laparoscopy): 2-4 mL/kg/hr (calculator uses 3 mL/kg/hr) Moderate (e.g. open cholecystectomy, open appendectomy): 4-6 mL/kg/hr (calculator uses 5 mL/kg/hr) Severe (e.g. bowel resection): 6-8 mL/kg/hr (calculator uses 7 mL/kg/hr

Do not use to provide comprehensive or definitive drug information.

1. Corcoran T, Rhodes JE, Clarke S, Myles PS, Ho KM. Perioperative fluid management strategies in major surgery: a stratified meta-analysis. Anesth Analg. 2012;114(3):640-51. 2. Giglio MT, Marucci M, Testini M, Brienza N. Goal-directed haemodynamic therapy and gastrointestinal complications in major surgery: a meta-analysis of randomized controlled trials. Br J Anaesth. 2009;103(5):637-46. 3. Noblett SE, Snowden CP, Shenton BK, Horgan AF. Randomized clinical trial assessing the effect of Doppler-optimized fluid management on outcome after elective colorectal resection. Br J Surg. 2006;93(9):1069-76. 4. Nisanevich V, Felsenstein I, Almogy G, Weissman C, Einav S, Matot I. Effect of intraoperative fluid management on outcome after intraabdominal surgery. Anesthesiology. 2005;103(1):25-32. 5. Shaw AD, Bagshaw SM, Goldstein SL, et al. Major complications, mortality, and resource utilization after open abdominal surgery: 0.9% saline compared to Plasma-Lyte. Ann Surg. 2012;255(5):821-9. 6. Maitland K, Babiker A, Kiguli S, Molyneux E. The FEAST trial of fluid bolus in African children with severe infection. Lancet. 2012;379(9816):613.

OBSERVATION.body_weight.v2, EVALUATION.intraoperative_fluid_dosing_adult_patients.v0