iThoughts

Solutions such as 4%/0.18% dex/saline and 5% dextrose should be used with caution as they risk hyponatraemia (especially in the elderly and paeds)
Adults should receive 50-100mmol sodium and 40-80mmol K per day in 1.5-2.5L of water by the oral, enteral or parenteral route
Non-particulate oral fluids should not be withheld for > 2 hrs prior to anaesthesia
Due to the risk of hyperchloraemic acidosis, balanced solutions should be used except in cases of hypochlorameia (eg vomiting)
Carbohydrate rich beverages 2-3hrs prior to anaesthesia may improve recovery
Mechanical bowel preparatory is not beneficial. If it is used, CSL should be used to correct electrolyte disturbances
In high risk patients, pre-op fluids should be aimed at a diving predetermined goals for cardiac output and oxygen delivery
Hypovolaemia due to bleeding should be treated with balanced crystalloid or colloid until red cells are available.

High molecular with HES solutions should be avoided
Balanced electrolyte solutions should be used if on ITU/HDU in preference to N/saline
If hyperkalaemia, the patient may be changed to 0.45% saline or dextrose/saline
Patients with Rhabdomyolysis should be treated aggressively with isotonic crystalloid

Post op fluids should be clearly recorded and accessible
Return to oral fluids as soon as possible
If oedematous, feed should be given in reduced water but improved nutrition will help to restore normal electrolyte partitioning

Where Hypovolaemia is in doubt, the response to 200ml boluses should be assessed
In orthopaedic or intra abdominal surgery, IV fluid should be given to obtain optimal stroke volume and supplemented by low dose dopexamine infusion