Common Pitfall in Post Operative Fluid and Electrolyte Management: A Retrospective Study in Two Tertiary Centers in...

Area of Science:

• Medical Science
• Clinical Practice
• Patient Care

Background:

• Post-operative fluid and electrolyte balance is critical for patient recovery.
• Current fluid management practices may lead to complications like hypokalemia.
• Standardized protocols are needed to ensure optimal patient care.

Purpose of the Study:

• To evaluate current fluid and electrolyte management practices in the post-operative period.
• To identify the incidence of hypokalemia and other electrolyte imbalances.
• To propose an appropriate fluid regime for post-operative care.

Main Methods:

• Retrospective analysis of drug charts and clinical notes of 758 surgical patients (January 2020 - January 2022).
• Inclusion criteria applied, resulting in 407 patients for data analysis.
• Manual review by three clinicians to assess fluid replacement, sodium, potassium, and glucose levels.

Main Results:

• Average fluid replacement was 2.5 L/day, with average electrolyte levels of Sodium 154 mmol/day, potassium 2.0 mmol/day, and glucose 125 mmol/day.
• Post-operatively, 97 patients (23.8%) developed hypokalemia, with 25 (6.1%) experiencing severe hypokalemia.
• A significant incidence of hypokalemia was observed, indicating a need for revised fluid management strategies.

Conclusions:

• Current post-operative fluid and electrolyte management requires optimization.
• A proposed simple pathway for fluid and electrolyte prescribing is suggested for the first post-operative day.
• The proposed pathway includes specific recommendations for water, sodium, chloride, potassium, and glucose to prevent imbalances.