Fluid and Electrolyte Management of the Surgical Patient Dr Abdollahi Afshar Hospital.

Fluid and Electrolyte Management of the

Surgical Patient

Dr Abdollahi

Afshar Hospital

Fluid therapy is often poorly taught poorly understood and

poorly done

lsquolsquoFluid therapy should be directed not only to Fluid therapy should be directed not only to effective volume expansion of a leaky effective volume expansion of a leaky circulation but also to micro vascular circulation but also to micro vascular protectionrsquoprotectionrsquo

Fluid and electrolyte management are paramount to the care of the surgical patient Changes in both fluid volume and electrolyte composition occur preoperatively intraoperatively and post operatively as well as in response to trauma and sepsis

Total Body Water

Who is having higher proportion of body weight as water And Why

1048699Males or Females

1048699Lean or Obese

1048699Young or elderly

Body Fluid CompartmentsBody Fluid Compartments

ICFICF55~7555~75

IntravascularIntravascularplasmaplasma

X 50~70 X 50~70 lean body weightlean body weight

ExtravascularExtravascularInterstitial Interstitial

fluidfluid

TBWTBW

ECFECF

34

14

bull Male (55) gt female (45)bull Most concentrated in skeletal musclebull TBW=06xBWbull ICF=04xBWbull ECF=02xBW

23

13

Total body water (TBW)

bull TBW varies with age gender and body habitus

bull In adult males= 55 of body weight

bull In adult female=45 of body weight

bull In infant = 80 of body weight

bull Obese patients have less TBW per Kg than lean body

adult

1= Intracellular fluid (ICF)=55 TBW or 30-40 BW

2= Extracellular fluid (ECF) =45TBW or 20 BW

Interstitial fluid =15 of body weight

Intravascular fluid or plasma volume

= 5 of body weight

Body compartment fluid

Example men with 70kg TBW= 5570 =385 L

ICF = 55 385 =212L

ECF = 45 385=173L

1 ISF = 15 70 = 105L

2 PV = 5 70 =35L

Fluid compartments

ICF