Perioperative fluid management is a key challenge during major surgery. Total Body Water Intracellular Fluid Extracellular Fluid. Careful fluid and electrolyte management is essential for the well being of the sick newborn infant. 1 2016 Kudsioglu et al. Perioperative fluid management In major surgical cases such as cardiac surgery, fluid passage to third space is 15-20 ml/kg/h, in premature infants it is 50 ml/kg/h.1 J Anesth Crit Care Open Access. This is an open access article distributed under the terms of the Creative Commons Attribution License, Fluid Management. It is associated with long in-patient stays, and has a high in-hospital and post-discharge morbidity and mortality, whether left ventricular ejection fraction (LVEF) is reduced (HFREF) or normal (HeFNEF).1,2 Congestion, or fluid overload, is a classic clinical feature of patients presenting with HF. Fluid therapy to restore and/or maintain tissue perfusion may affect patient outcomes in perioperative, emergency, and intensive care. 4. Fluid Management Tong Joo (TJ) Gan, MD, FRCA, FFARCS (I) Professor of Anesthesiology Vice Chairman Clinical Research Duke University Medical Center Durham, North Carolina. 1 , 2 Major surgical operations require a period of fasting during which oral antidiabetic medications . Proper management of fluid and electrolytes facilitates crucial homeostasis that allows cardiovascular perfusion, organ system function, and cellular mechanisms to respond to surgical illness. MAINTAINENCE FLUID DURING SURGERY - The maintenance fluid used during surgery should be isotonic such as 0.9% sodium chloride or Ringer lactate /Hartmann's solution in infants. Total Body Water constitutes 50-70 % of total body weight fat contains little water, the lean individual has a greater proportion of water to . The cytokine response to infection and injury, the so-called "Systemic Inammatory Response Syndrome", has a major . resuscitation are : 1. adults with >15-20% burns 2. child with 10% burns 3. electric burn with haemochromogens in the urine 4. the extremes of age or elderly patients with preexsisting cardiac or . Intravenous fluid management in patients with acute lung injury and the acute respiratory distress syndrome (ALI/ARDS) can be particularly challenging. FLUID REQUIREMENTS Sources Losses (35ml/kg/day) Urine Water 1500 ml Food 800 ml Stool 200 ml Oxidation 300 ml Skin 500 ml (0.5~1ml/kg/hr) (12ml/kg/day) 1500 ml Resp. 1 L. 13. 13,14 The guidelines are based on a meta-analysis of randomized trials that reports a . Title: PowerPoint Presentation Author: Conclusion. Intravenous Fluids +/- additives should be changed every 24 hours including patient stock bags. The main concerns are missing a potentially treatable underlying cause or complication of ARDS. Fluid and Electrolyte Management of the Surgical Patient Dr Abdollahi Afshar Hospital. Fluid management does not use a one-size-fits-all approach. The occurrence of one or more postoperative complications adversely effects both short-term and long-term survival and increases healthcare costs [1,2].The prevention of postoperative morbidity is a key factor in providing high-quality, high-value . 5. 4 MCQs Surgery MCQs and EMQs Preoperative Management Questions D. Should be treated with intravenous beta-blockers or glyceryl trinitrate if emergency surgery is necessary E. Treatment should be discontinued 2 weeks before elective surgery 4. (2015) Controversies of the Anesthetic Management of Lumbar Drains for Aortic Surgery. Fluid Management PowerPoint Presentation. 1. Knowledge of the compartmentalization of body fluids forms the basis for understanding pathologic shifts in these fluid spaces in disease states. Winner of the Standing Ovation Award for "Best PowerPoint Templates" from Presentations Magazine. Proper management of fluid and electrolytes facilitates crucial homeostasis that allows cardiovascular perfusion, organ system function, and cellular mechanisms to respond to surgical illness. Free Quiz: http://adv.icu/38hADDK 10% off EACH Month your MyNurisngMastery subscription: https://adv.icu/. Many colorectal surgeons rely on traditional theories and approaches in addressing perioperative fluid management issues. To provide recommendations for intravenous fluid management during and after surgery in children of all ages. dr abdollahi afshar hospital. Porcine Management and Surgical Procedures - Title: PowerPoint Presentation Author: Dipa Last modified by: Dipa Created Date: 12/12/2012 2:52:37 PM Document presentation format: . Estrera, A. et al., 2016. In the absence of tools directly assessing . Tract Total 2600 ml 400 ml Total 2600 ml Practically Daily Input/Output balance = +500ml Objectives To define malnutrition and discuss its impact on the surgical patient To identify malnutrition in hospitalized surgical patients. One of the most common uses of fluid therapy is for patient support during the perianesthetic period. Fluid and Electrolyte Management of the Surgical Patientu000b Hashmi. To provide recommendations for the management of electrolyte imbalance in the peri-operative period. Historically, fluid management has been as much an art as a science - a fine line must be negotiated between an adequate resuscitation and one of fluid overload. The optimal type of fluid to be administered during major surgery remains to be determined. Download Presentation. Fluid therapy is an important component of management for many diseases that affect sheep, goats, and cervids. Management is with bowel rest, intravenous antibiotics, and potential surgical intervention if a major leak. 500 mL fluids bags should be used within the neonatal population - both term and preterm. - Maintenance fluid to be calculated by Holliday and segar Extracellular fluid - water outside of cells in tissues and body spaces such as the chest and abdomen 3. The goal of preoperative fluid management is for the patient to be in a hydrated and euvolemic state when . 2,3 The ERAS protocols have been associated with . Resectoscope: An endoluminal surgical device compris-ing an endoscope (hysteroscope or cystoscope), sheaths for inow and outow, and an ''element'' that interfaces a spe-ciallydesignedelectrode(orpairofelectrodes)witharadio-frequency electrosurgical generator Purpose and Scope The objective of this guideline is to provide clinicians Malnutrition in surgical patients Surgical Nutrition Training Module Level 1 Philippine Society of General Surgeons Committee on Surgical Training. - Neonates in the first 48 hours of life should be given dextrose during surgery. ANATOMY OF BODY FLUIDS Total Body Water Intracellular Fluid Extracellular Fluid Osmotic Pressure. Fluctuations in Spinal Cord Perfusion Pressure: A Harbinger of Delayed Paraplegia After Thoracoabdominal Aortic Repair, AATS Aortic Winner of the Standing Ovation Award for "Best PowerPoint Templates" from Presentations Magazine. Major surgery is a considerable physiologic insult that can be associated with significant morbidity and mortality. They can present with abdominal pain and fever, typically 5-7 days post-operatively. Fluid therapy in Burns Fluid resuscitation in first 24 hours Fluid therapy from 24 to 48 hours Fluid therapy after first 48 hours Indication of I.V. FLUID AND ELECTROLYTE MANAGEMENT OF THE SURGICAL PATIENT BODY FLUIDS TOTAL BODY WATER Water 50-60% total body weight Lean tissues higher water content Young adult M 60% total body weight is TBW Young adult F it is 50% TBW adjusted 10-20% for obese & 10% for malnourished Newborns 80% total body weight 1 yr of age 65% total body weight Excessive loss due to hypermetabolism, pyrexia, hyperventilation. For children 10 . Management of the Trauma Patient Hieu Ton-That, MD, FACS Loyola University Medical Center Division of Burns, Trauma and Surgical Critical Care. Although inappropriate fluid therapy is rarely reported as being responsible for patient harm, a 1999 report from the National Confidential Enquiry into Perioperative Deaths Fluid overload is frequently found in acute kidney injury patients in critical care units. Zero-balance fluid therapy should be aimed for. case presentation 6. Cardillo, S. M, Berstein, W. J. Fluid Resuscitation/Treatment of Dehydration For dehydration,shock,blood loss-isotonic Normal Saline or Lactated Ringers Give 20ml/kg as bolus.then repeat your exam Repeat bolus if symptoms of dehydration are still present After patient shows improvement you can change to glucose containing IV fluids Calculate fluid need based on degree of dehydration and "Early Recovery after Surgery Fluid Management" is the property of its rightful owner. Fluid Management . Abstract and Figures. 1. . Fluid and electrolyte goals and deficiencies must be defined for individual patients to provide the appropriate combination of resuscitation and maintenance fluids. Fluids and anesthesia. Fluid Management 1 / 45. Guidance. Fluid management for an infant with gastroschisis can be complex and requires strict attention to the rapidly changing needs of the neonate, who may be critically ill. After birth, neonates with gastroschisis are subject to tremendously increased insensible fluid losses related to exposure of the eviscerated bowel. Postoperative care units are run by an anesthesiologist or a surgeon, or a team formed of both. Fluid therapy is often poorly taught, poorly understood and poorly done 'Fluid therapy should be directed not only to effective volume expansion of a leaky circulation but also to micro vascular protection'.. Fluid and electrolyte management are paramount to the care of the surgical patient. World's Best PowerPoint Templates - CrystalGraphics offers more PowerPoint templates than anyone else in the world, with over 4 million to choose from. Postoperative abdominal surgery: Fluid requirements may be twice or three times that noted above. Archives of Surgery, 1955 138 patients (99 abdominal, 39 hernias) 30 day mortality - 28% - 47% emergency surgery, 9% elective Morbidity - 70% - 56% surgical complications Risk factors included transfusion, ASA, serum sodium, creatinine Perioperative Mortality After Non-hepatic General Surgery IV therapy is the fastest way to replenish fluids and electrolytes in an infant or child who has severe dehydration, especially if he or she has a serious . Maintenance of water ,sodium and potassium for surgical water losses in patients undergoing anesthesia For surgical patients you must consider these additional factors in your fluid replacement . Enhanced Recovery after Surgery (ERAS ) refers to patient-centered, evidence-based, multidisciplinary team developed pathways for a surgical specialty and facility culture to reduce the patient's surgical stress response, optimize their physiologic function, and facilitate recovery.These care pathways form an integrated continuum, as the patient moves from . Patients with diabetes undergo surgical procedures at a higher rate than do nondiabetic people.