Use the principles described in Fluids basics to approach this problem logically. Go back to those pages to look things up when necessary.
A complicated case. But exactly the same principles apply.
5 days after a liver transplant, a 48 year old man has a pyrexia of 40.8 degrees C. His charts for the last 24 hours reveal:
2 units (350 ml each)
On examination he has a tachycardia. His supine BP is OK, but you can’t sit him up to check his erect BP. His serum [Na+] is 140 mmol/l. Questions:
- How much IV fluid is he likely to need over the next 24h, assuming these outputs remain the same? (it is of course unlikely that they will be quite the same)
- What fluids would you use?