An 8 year-old, 26 kg female comes to the outpatient surgery center for knee
surgery after sustaining an ACL tear while playing lacrosse one week ago. The
patient last had apple juice 4 hours prior to arrival into the operating room. How
much fluid replacement will she require in the first hour of surgery in order to
restore her to euvolemia?
a) 88 mL
b) 132 mL
c) 264 mL
d) 528 mL
e) 1056 mL
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Answer
Answer d. Using the 4:2:1 rule, this patient’s “maintenance” fluids can be
calculated to be 40+20+6=66 mL/hour. Thus, if she has been NPO for 8 hours,
she has a deficit of 66 x 8 = 528 mL, which should be repleted in addition to any
ongoing losses (blood loss or evaporative losses) in order to establish euvolemia.
Notes
- This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.
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