TY - CHAP M1 - Book, Section TI - Fluid and Electrolyte Management of the Surgical Patient A1 - Neal, Matthew D. A2 - Brunicardi, F. Charles A2 - Andersen, Dana K. A2 - Billiar, Timothy R. A2 - Dunn, David L. A2 - Kao, Lillian S. A2 - Hunter, John G. A2 - Matthews, Jeffrey B. A2 - Pollock, Raphael E. Y1 - 2019 N1 - T2 - Schwartz's Principles of Surgery, 11e AB - Key PointsProper management of fluid and electrolytes facilitates crucial homeostasis that allows cardiovascular perfusion, organ system function, and cellular mechanisms to respond to surgical illness.Knowledge of the compartmentalization of body fluids forms the basis for understanding pathologic shifts in these fluid spaces in disease states. Although difficult to quantify, a deficiency in the functional extracellular fluid compartment often requires resuscitation with isotonic fluids in surgical and trauma patients.Alterations in the concentration of serum sodium have profound effects on cellular function due to water shifts between the intracellular and extracellular spaces.Different rates of compensation between respiratory and metabolic components of acid-base homeostasis require frequent laboratory reassessment during therapy.Although active investigation continues, alternative resuscitation fluids have limited clinical utility, other than the correction of specific electrolyte abnormalities.Enhanced recovery after surgery (ERAS) protocols have markedly changed perioperative fluid management and are being used more frequently. ERAS minimizes perioperative fluid administration and focuses on early enteral intake to reduce morbidity associated with IV fluid administration.Most acute surgical illnesses are accompanied by some degree of volume loss or redistribution. Consequently, isotonic fluid administration is the most common initial intravenous fluid strategy, while attention is being given to alterations in concentration and composition.Some surgical patients with neurologic illness, malnutrition, acute renal failure, or cancer require special attention to well-defined, disease-specific abnormalities in fluid and electrolyte status. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/19 UR - accesssurgery.mhmedical.com/content.aspx?aid=1175968573 ER -