Fluid management pattern among post laparotomy patients at Muhimbili National Hospital, Dar Es Salaam Tanzania

Abstract

ABSTRACT Background:Fluid management to post-operative patient have remained a challenge tomany health facilities especially in Africa and the world at large, the right amount and type of fluid has remained uncertain to many institutions. Methodology;A total of two hundred and eighty eight patients who under-went laparotomy between July, 2017 to January 2018 at MNH were studied prospectively in adescriptive hospital-based cross-sectional study where the patterns of their fluid management was studied and analysed using Chi-square as per managing physician/surgeon where input/output and hydration status were recorded in general surgical ward at MNH. Results:Results has shown that, there is adifference among the type and amount in relation to fluid prescribed by surgeon andthe fluid received by patient in the ward. Colonic surgery was among the mostcommon operation done, the average weight of the patientswas 64kg with average of 2781mls of fluid prescribed and 2054mls were received. The male female ratio was 1:1; elective cases were more compared to emergency cases. Dextrose saline with ringer lactate was preferred combined fluid given to patients and dextrose saline no in combined form. 87% of patients were well hydrated and 7 patients were hyponatremic and 31 patients were hypernatremic. Conclusion and recommendation:Physiological factor should be considered in determining type and amount of fluid to be given and other factors such as sex, age, weight, renal status, electrolyte status. There is need for establishment of functional protocol on fluid management and patients be managed as per physician.