IV fluids during surgery.

During an attempt to measure renal function during operation in six patients undergoing major abdominal surgery involving intestinal resection and blood loss in excess of 300 ml, it became apparent that the conventional recommendation for i.v. crystalloid fluid of 5-10 ml kg-1 h-1 was not sufficient to maintain cardiovascular stability and urine output, but a volume of 15 ml kg-1 h-1, given to a subsequent six patients, was adequate. Administration of low sodium (glucose) solutions also produced biochemical abnormalities of a severity not documented previously. A survey of the published literature on volumes of crystalloid fluids used supports the contention that, during major surgery, crystalloid requirements may be of the order of 10-15 ml kg-1 h-1 rather than 5-10 ml kg-1 h-1.