Fluid and electrolyte therapy

Abstract

Abstract Fluid and electrolyte therapy of the surgical patient is an integral and vital step of the metabolic and nutrition perioperative care. Fluids and electrolytes play an important role in several metabolic pathways and cellular functioning, affecting organelles such as the mitochondria. Also, there is a close relationship between fluid and electrolyte balance and nutrition (both oral and artificial). Digestion and absorption of nutrients are linked to the secretion and absorption of water and electrolytes. Therefore, it s of utmost importance to discuss fluid and electrolyte physiopathology to adequately prescribe both of them. Current good practice indicates that patients should not be allowed to solely receive intravenous venous fluids throughout their surgical journey (Fearon et\xa0al., 2005; Padhi et\xa0al., 2013). Instead, avoiding long preoperative oral fasting periods and allowing early postoperative oral or enteral intake are the gold standards for adequate quality care (Fearon et\xa0al., 2005). Nonetheless, fluid and electrolyte therapy is still mandatory under certain circumstances such as intraoperatively or when increased losses occur. In this regard, fluids and electrolytes should be individually tailored based on the different surgical phases and the organic response to trauma, as well as the patient s sex, age, and clinical condition. Water is the main body component as it represents approximately 60% of the overall weight in an adult individual. Two-thirds of the water are in the intracellular compartment and one-third in the extracellular (intravascular and interstitial) space. Shifts between the two compartments are continuous according to various factors and regulated by the cell wall. Most factors relate to intra- and extracellular ion concentrations, which on the other hand depend on various other variables such as disease state, drug usage, hydration, nutritional status, patient sex, and age.