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Latest revision as of 02:22, 25 September 2026
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
Click for Answer
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.