Operating room IVF requirements

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OR IVF requirements

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Instructions

Select a degree of tissue trauma from minimal to emergency trauma from the table below:

Degree of tissue trauma	Fluid Requirements
Minimal (i.e. eye cases, laparscopic cholecystectomy)	1 - 2 mL/kg/hr
Low (i.e. arthroscopies, ENT)	3 - 4 mL/kg/hr
Moderate (i.e. total joint replacements)	5 - 6 mL/kg/hr
Severe (i.e. bowel resection, total hip replacement)	7 - 8 mL/kg/hr
Emergency (i.e. gun shot, car accident-severe injuries)	10 - 15 mL/kg/hr

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.

Example

A 50 kg patient is scheduled for a laparoscopic cholecystectomy. What are the maintenance fluid requirements for this patient during surgery? Answer: 200 mL/hr. See example below:

Doesn't work, just an example

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.

Signs of Fluid Loss (hypovolemia)

	Fluid Loss (expressed as % of body weight)
Sign	5%	10%	15%
Mucous membranes	Dry	Very Dry	Parched
Sensorium	Normal	Lethargic	Obtunded
Orthostatic changes in pulse or BP	Mild	Present	Marked
Urinary flow rate	Mildly decreased	Decreased	Markedly decreased
Pulse rate	Normal or increased	Increased	Markedly increased
Blood Pressure	Normal	Mildly decreased	Decreased

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J.U.S.T - Faculty of Nursing

minimal tissue trauma
low tissue trauma
moderate tissue trauma
severe tissue trauma
emergency trauma
weight in kg

IV rate up to mL/hr

Fluid Loss(expressed as % of body weight)

Sign

5%

10%

15%

Fluid Loss
(expressed as % of body weight)