Читать книгу Ottawa Anesthesia Primer - Patrick Sullivan - Страница 23

Disorders of fluid and electrolytes are common and may require correction in the perioperative period. Generally, all fluid and electrolyte disorders should be corrected prior to elective surgery.

Patients with acute and chronic renal failure have abnormal fluid, electrolyte, and drug excretion and may require perioperative dialysis management.³¹ Patients should be asked about the relative progression (or stability) of their disease, and particular attention must be paid to fluid and hemodynamic management in order to avoid further renal insult. Patients on hemodialysis (HD) should also be asked about their schedule so arrangements can be made to perform HD within the 24-hr period prior to surgery. Potassium levels do not reach a steady state between the intra and extracellular compartments for several hours after HD; hence, measurement of electrolytes (including potassium) immediately following HD is generally not helpful, and it may be misleading, as potassium flux has not reached a steady state.