- Joined
- Mar 12, 2005
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SOOOOOOOOO........WHAT IS IT?????
FLUID REPLACEMENT
Reading the responses in the Jet's Academia B.S. thread rekindled a conversation I remember from my intern year with a cardiology fellow during my cards rotation.
He commented on how anesthesiologists needlessly FLOODED patients during surgery with IVF, and he didnt understand it.
I remembered this conversation when I was a resident...and since I was taught to replace NPO loss, insensible loss, 3:1 for blood loss......I concluded when I was a resident that the cardiology fellow was uneducated.
Eleven years into private practice, I now conclude that cardiology fellow was correct.
I think on alotta cases we use way too much IV fluids.
Don't misintrepret, though.....
cuz even on dialysis patients, history-of-CHF patients, etc.....there are times where you have to...in order to maintain perfusion... flood them intraoperatively, and deal with the sequelae in the ICU...
but I think our resident education on empiric fluid administration leaves too many patients overloaded.
Doesnt matter on ASA 1-2 patients......I had some kinda GI bug at work today so had a CRNA start an IV on me.....Zofran, Decadron, and 3 liters later I felt like a new man....
but pump 3 liters IVF in the wrong patient on the wrong case because "the book" says you should.......I think is wrong.
FLUID REPLACEMENT
Reading the responses in the Jet's Academia B.S. thread rekindled a conversation I remember from my intern year with a cardiology fellow during my cards rotation.
He commented on how anesthesiologists needlessly FLOODED patients during surgery with IVF, and he didnt understand it.
I remembered this conversation when I was a resident...and since I was taught to replace NPO loss, insensible loss, 3:1 for blood loss......I concluded when I was a resident that the cardiology fellow was uneducated.
Eleven years into private practice, I now conclude that cardiology fellow was correct.
I think on alotta cases we use way too much IV fluids.
Don't misintrepret, though.....
cuz even on dialysis patients, history-of-CHF patients, etc.....there are times where you have to...in order to maintain perfusion... flood them intraoperatively, and deal with the sequelae in the ICU...
but I think our resident education on empiric fluid administration leaves too many patients overloaded.
Doesnt matter on ASA 1-2 patients......I had some kinda GI bug at work today so had a CRNA start an IV on me.....Zofran, Decadron, and 3 liters later I felt like a new man....
but pump 3 liters IVF in the wrong patient on the wrong case because "the book" says you should.......I think is wrong.