![]() ![]() 13 Further, develop a plan for how fluids will be used in an anesthesia-related emergency based on individual comoribund conditions, such as hypertrophic cardiomyopathy and oliguric/polyuric renal disease. For example, patients with uremia benefit from preanesthetic fluid administration. 12 Preanesthetic fluids and preparing the sick patientĬorrect fluid and electrolyte abnormalities in the sick patient as much as possible before anesthesia by balancing the need for preanesthetic fluid correction with the condition requiring surgery. 11 A fluidconsuming “third space” has never been reliably shown, and, in humans, blood volume was unchanged after overnight fasting. 9,10Note that infusion of 10–30 mL/kg/hr LRS to isoflurane-anesthetized dogs did not change either urine production or O2 delivery to tissues. Those high fluid rates may actually lead to worsened outcomes, including increased body weight and lung water decreased pulmonary function coagulation deficits reduced gut motility reduced tissue oxygenation increased infection rate increased body weight and positive fluid balance, with decreases in packed cell volume, total protein concentration, and body temperature. The paradigm of “crystalloid fluids at 10 mL/kg/hr, with higher volumes for anesthesia-induced hypotension” is not evidence-based and should be reassessed. ![]() Preoperative volume loading of normovolemic patients is not recommended. 6 8 In the absence of evidence-based anesthesia fluid rates for animals, the authors suggest initially starting at 3 mL/kg/hr in cats and 5 mL/kg/hr in dogs. Current recommendations are to deliver, 10 mL/kg/hr to avoid adverse effects associated with hypervolemia, particularly in cats (due to their smaller blood volume), and all patients anticipated to be under general anesthesia for long periods of time (Table 4). The primary risk of providing excessive IV fluids in healthy patients is the potential for vascular overload. When fluids are provided, continual monitoring of the assessment parameters is essential (Table 1). ![]()
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