Patients undergoing intestinal surgery are well known to require more fluid replacement than might otherwise be expected. This patient will no doubt have preoperative fluid deficits, because he has not been eating or drinking, and has also undergone a bowel prep. Intraoperatively, the patient will lose blood, and there is also likely to be a significant insensitive loss from the intestines exposed to air. Fluids—crystalloids or blood products—will be required to ensure the preservation of renal and cardiovascular function, maintaining urine output at normal levels.
Many factors make fluid management in the perioperative setting different from any other situation. Preoperative fasting, insensible fluid losses, blood loss from the surgical site, postoperative dietary restrictions, and nasogastric tube drainage require the use of replacement fluids. Such fluids include crystalloids, colloids, and blood products. Administration of fluids is guided by the nature of the bodily fluid loss, and the patient’s disease process.
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