Review Note
Last Update: 02/27/2025 04:30 AM
Current Deck: ACG Part 2::Thoracic SSU
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Commit #291083
SS_TS 1.16 Identify fluid management issues specific to thoracic surgery and discuss fluid management of the patient having lung resection
Back
Commit #291083Due to hydrostatic effects, excess IVF can cause shunting and increased pulmonary oedema especially in the dependent lung during prolonged surgery.
- Aim for euvolaemia (dry lung) with balanced crystalloid; avoid being over-restrictive (2–3mL/kg/h not been shown to be detrimental).
- For cases such as oseophagectomy, may need to replace losses from dehydration.
For pulmonary resection surgery :
- Total positive fluid balance in the first 24-hour perioperative period should not exceed 20 mL/kg.
- For an average adult patient, crystalloid administration should be limited to <3 L in the first 24 hours.
- No fluid administration for third-space fluid losses during pulmonary resection.
- Urine output >0.5 mL/kg/h is unnecessary
- If increased tissue perfusion is needed postoperatively, it is preferable to use invasive monitoring and inotropes rather than to cause fluid overload.
Millers Anaesthesia
Oxford Handbook Anaesthesia 5th edition.