Perioperative Fluid and Electrolyte Management in Paediatric Patients

1. M.D., D.A., Prof. in Anaesthesiology 2. M.D., D.A. (PDCC) Department of Anaesthesiology Amrita Institute of Medical Sciences and Research Center. Elamakkara, Cochin, Kerala 682 025 Correspond to : Dr. Suresh G. Nair E-mail: [email protected] Introduction Fluid management of the paediatric surgical patient is a critical element in the care of infants and children who are sensitive to small degrees of dehydration. Complex surgical procedures are often associated with rapid changes in fluid requirements necessitating frequent assessment and modifications of fluid therapy. In the operating room, the fluid requirements may rapidly change during the conduct of anaesthesia and surgery, coincident with changes in temperature, metabolism and fluid volume shifts. The trauma, haemorrhage and tissue exposure associated with surgery shifts body fluids between compartments, necessitating fluid replacement with solutions that compensate for energy, water, protein and electrolyte losses. The anaesthesiologist must determine the nature and magnitude of these losses and be alert both to the obvious fluid losses of serum and urine and to hidden fluid losses, which can occur, with insensible loss and third space loss of fluid.