Intraoperative Fluid Management and Blood Transfusion Essentials

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Maintenance Fluids • Hourly basal Fluid Requirement is approximately 100-140 ml/hr for most adults • Add in blood loss: – Crystalloid replacement (balanced salt solutions): 3-4 ml of crystalloid per 1 ml of blood loss – Colloid or blood product replacement: 1 ml of solution per 1 ml of blood loss
Third Spacing • Controversial Subject • Concept is that local trauma causes edema to develop, and that this edema fluid does not maintain the usual connection between interstitial and intravascular spaces • Greatest third space losses: open laparotomies (4-6 ml/kg/hr possibly), open thorax with inflamed pleura (perhaps 2-4 ml/kg/hr)
Page 1 and 2: Intraoperative Fluid Management and
Page 3 and 4: Perioperative Fluid “Stressors St
Page 5 and 6: Perioperative Fluid “stressors st
Page 7: Fluid Deficit (cont) • So an 80 k
Page 11 and 12: So is third third spacing overrated
Page 13 and 14: Rational Fluid Management Plan for
Page 15 and 16: Crystalloids • Approximately 25%
Page 17 and 18: Fluid Fluid D5W 0.9% N.S. L.R. Norm
Page 19 and 20: • LR: Which crystalloid to select
Page 21 and 22: Introduction to Transfusion RBCs, R
Page 23 and 24: Therapeutic Dilemma Anemia is bad
Page 25 and 26: Other infectious complications of t
Page 27 and 28: Metabolic Complications of Transfus
Page 29 and 30: Anemia in Elective Surgical Patient
Page 31 and 32: So Goodnough et al. are recommendin
Page 33 and 34: ASA Practice Guidelines • Transfu
Page 35 and 36: RBC Transfusion Modifiers Primary a
Page 37 and 38: Indications for Fresh-frozen plasma
Page 39 and 40: Fibrinogen concentration vs blood v
Page 41 and 42: Platelet transfusion won’t won t

Intraoperative Fluid Management and Blood Transfusion Essentials

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