Impending Hypovolemia in Elderly Patients Under Anesthesia

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Pattharaporn Sombood
Kornnika Yankan
Ingpisa Sritanapongsa
Alisa Wanpetch
Phongthara Vichitvejpaisal


Body fluids play a critical role in the circulatory system, biochemical processes, regulation of body temperature, and metabolism. Dehydration, which can cause electrolyte imbalances, is a common problem in elderly patients. Thirst is reduced in aging and under certain diseases, as well as side effects of drug use. In addition, it can lead to life-threatening complications, multi-system organ failure, and death. Patients planning for surgery should have nothing by mouth and receive intravenous fluids to maintain their pathophysiologic conditions under anesthetic drugs that can suppress myocardium function. Vasodilatation can result in hypotension in patients with hypovolemia, in which case fluid replacement may not be necessary while vasopressors should be considered. Patients with blood loss of less than 20% of their total blood volume must be monitored for early changes in vital signs, urine output, and serum osmolarity. However, in cases of massive blood loss, supplemental fluids or blood transfusions are urgently required. Circulatory volume should be assessed with central venous pressure or pulmonary capillary wedge pressure. In the postoperative period, patients must be continuously administered intravenous fluids as appropriate to eliminate excessive anesthetics and support organ function

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