Table A15-1 Fluid Deficits

Calculation of postoperative fluid deficit

Estimated fluid requirement (EFR) per hour:
First 10kg: 4cc/kg (100cc/kg/day)
Second 10kg: 2cc/kg (50cc/g/day)
Above 20kg: 1cc/kg (25cc/kg/day)
Example: EFR for a 70 kg patient = (10 4) + (10 2) + (50 l)
= 40 + 20 + 50
= 110 cc/h
Estimated fluid deficit (EFD)=EFR times the number of hours since last oral intake:
Example: EFD for 70-kg patient NPO (nothing by mouth) for 8 hours
EFR 8=110cc/h8h=880cc
Replacement of blood losses:
Crystalloid fluid: 3 times estimated blood loss (EBL)
Colloid or blood: 1 times EBL
Example: For EBL of 400cc, crystalloid fluid replacement should be 3400=1,200cc
Total postsurgical fluid deficit (TPFD):
EFD+(blood losses 3)fluid replaced by anesthesia during surgery
Example: A 70-kg patient is NPO for 8 hours, has 400cc of surgical blood loss, and receives
1,500cc of crystalloid during surgery
TPFD=880cc+1,200cc1,500cc=580cc
Insensible losses are generally negligible in most orofacial procedures.

Table A15-2 Types of Intravenous Fluid (Milliequivalents/L)

IV solution NA K Cl Bicarbonate Calories

Ringers lactate 130 4 109 28 0

Ringers solution 147 4 155 0 0
Normal saline (0.9%) 154 0 154 0 0
Lactated Ringers with dextrose 130 4 109 28 170
Dextrose 2.5% in NaCl 0.45% 77 0 77 0 85
Dextrose 5% in Ringers lactate 148 4 156 0 170
Dextrose 5% in 2% NaCl 34 0 34 0 170
Dextrose 5% in 0.33% NaCl 56 0 56 0 170
Dextrose 5% in 0.45% NaCl 77 0 77 0 170
Dextrose 5% in 0.9% NaCl 154 0 154 0 170
Dextrose 10% in 0.9% NaCl 154 0 154 0 340
Dextrose 5% in water 0 0 0 0 200
Dextrose 10% in water 0 0 0 0 400