Operating Room IVF Requirements
Instructions
Select a degree of tissue trauma from minimal to emergency trauma from the table below:
Trauma Level | Example | IV Fluid Requirement |
---|---|---|
Minimal | eye cases, laparscopic cholecystectomy | 1–2 mL/kg/hr |
Low | arthroscopies, ENT | 3–4 mL/kg/hr |
Moderate | total joint replacements | 5–6 mL/kg/hr |
Severe | bowel resection, total hip replacement | 7–8 mL/kg/hr |
Emergency | gun shot, car accident–severe injuries | 10–15 mL/kg/hr |
Formula: Total IVF Maintenance Requirements
Insensible loss + 3rd space loss requirements
- Insensible loss = 1-2 mL/kg/hr
- 3rd space loss requirements depend on the type of trauma related to the surgical procedure that is being performed.
Note:
- Adjust IV fluids to maintain urine output of 1 mL/kg/hr. For comparison, oliguria is defined as a urine output of less than 0.5 mL/kg/hr.
- Infuse colloid solution to replace blood loss > 20% of patient's circulating volume.
Signs of Fluid Loss (hypovolemia)
Sign | 5% | 10% | 15% |
---|---|---|---|
Mucous Membranes | Dry | Very dry | Parched |
Sensorium | Normal | Lethargic | Obtunded |
Orthostatic Changes in Pulse or BP | Mild | Present | Marked |
Urinary Output | Mildly decreased | Decreased | Markedly decreased |
Heart Rate | Normal or increased | Increased | Markedly increased |
Blood Pressure | Normal | Mildly decreased | Decreased |
Example
A 50 kg patient is scheduled for a laparoscopic cholecystectomy. What are the maintenance fluid requirements for this patient during surgery?
- Tissue trauma is minimal
- Insensible loss = 1–2 mL/kg/hr
- 3rd space loss requirement = 1–2 mL/kg/hr
- Patient weight = 50 kg
2 × 50
4 × 50
The answer is 100–200 mL/hr.