Intraoperative Fluid Dosing in Adult Patients
Doses IV fluids intraoperatively.
This dosing tool is intended to assist with calculation, not to provide comprehensive or definitive drug information. Always double-check dosing of any drug and consult a pharmacist when necessary.
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. This calculator provides a base hourly fluid requirement, fluid deficit, and hour-by-hour fluid requirement based on surgical needs.
Advice
- Fluid output should be monitored during operations to evaluate tissue perfusion (0.5 mL/kg/hr urine in patients with Foley catheters may help guide decisions).
- For most healthy patients with few co-morbidities undergoing minimally invasive procedures (i.e., in the outpatient setting) such as laparoscopic procedures, eye surgery, and other short cases, 1–2 L of a balanced electrolyte solution provides effective rehydration.
- As always, use clinical judgment in order to fully evaluate a patient’s fluid requirement.
- In longer cases, those with expected major fluid shifts, or with patients who cannot tolerate large amounts of IV fluid, consider the use of adjuvant colloid solutions to help maintain intravascular blood volume.
- Consider special cases such as patients undergoing GI surgery who have had bowel prep and may have excess fluid loss and greater requirements than the average patient.
Critical Actions
- Be wary of fluid management in patients who cannot tolerate excessive amounts of IV fluids, as this can result in decreased healing time and increased hospital stays with complications.
- Other intraoperative issues such as hypotension, tachycardia, and even EKG changes can often be attributed to the patient being severely hypovolemic and undergoing the stress of surgery, and, as such, the patient should be hydrated appropriately.