Intravenous fluid-associated morbidity in postoperative patients

Abstract

Introduction: There is marked variation in postoperative fluid prescribing which may contribute to postoperative morbidity. However, there are few data regarding the overall incidence of fluid associated morbidity in postoperative patients.

Patients and methods: Data regarding fluid and electrolyte prescription, fluid balance and intravenous fluid associated morbidity were prospectively collected from 71 patients representing 173 patient days of intravenous fluid therapy.

Results: There was no correlation between fluid and electrolytes prescription and pre-operative weight, serum electrolyte levels or ongoing fluid losses. 17% of patients developed significant fluid associated morbidity. 7 patients developed a tachyarrhythmia, which was associated with the prescription of inadequate maintenance potassium. 5 patients developed fluid overload, associated with excessive fluid volume and sodium administration.

Conclusions: Surgical house-staff do not appear to use the available fluid balance information when prescribing. The introduction of fluid prescribing protocols may improve practice. This study provides an accurate measure of fluid-associated morbidity in order to measure the efficacy of such protocols.