Why so much IV fluid?

[dtread]

I had IV line in for at least a day after surgery. When they finally got me to the scale to weigh me two or three days after surgery I looked at the reading and told them that their scale was broken. The nurse said that the scale was right, so I said "well, how the hell did I gain 20 pounds"? She said it was water weight gained from the IV fluid. I checked and a gallon weighs about 8 pounds. So I would have had about 2.5 gallons of IV fluid infused into me. No wonder I felt like crap. On top of that, the entire first day after surgery I had an unquenchable thirst and was sipping water all day, probably due to the anesthetic, which I guess dehydrates you. In the following days they gave me shots of the diuretic, Lasix. After nine days in the hospital I lost all the water weight plus left the hospital 3 pounds lighter than when I arrived.

So, does anybody know why they give you such a large quantity of IV fluid? If I didn't even have the surgery and was given 2.5 gallons of IV fluid I am sure I wouldn't feel very good. I am sure some of it is for antibiotics, and some for pain killer, but 2.5 gallons?

 

[Nancy]

I'd like to know the answer to that question too. Not only is it IV fluid, but it is a saline solution which is absolutely terrible for folks with CHF. Joe always gained about 15 pounds while in the hospital, in spite of being on diuretics there.

Most of the time the IVs just drip away with no added medications, just loading up the body.

And right along with this is the very salty hospital diet. I did everything but hire a lawyer to try to get hospitals to provide Joe with a low sodium diet. Only one hospital even tried to help out, and that dietician was wonderful and caring.

The rest of them I could have thrown into the ocean for all they were able to do.

So people with CHF, keep this in mind when hospitalized. You will be pumped full of "normal" saline solution, which may be way too much for your particular system, and your hospital won't accommodate your low sodium diet.

Plan on coming home in CHF and having to spend the next month getting rid of what the hospital did to you.

This is one of my big complaints and I wrote volumes to hospital administrations.

I even brought home cooked meals to Joe while he was hospitalized, just to try to save him this kind of grief afterwards.

 

[skeptic49]

Horror stories, I must say. What's with all the saline and salty food? It's amazing that they do this in hospitals, especiaslly to people with CHF...literally killing them with kindness!

I'm going to pack a lunch when I have to go in. Thanks for the heads up.

Jim

 

[Jkm7]

My first OHS, I gained 15 pounds during surgery. The second, I gained 18 pounds. I was not permitted to leave the hospital until I lost it all which I did in short order.

Some of the water has to do with the heart/lung machine I think.

 

[Lisa in Katy]

Most patients are dehydrated after surgery. So my guess is that they give you way more fluid than you would normally need because your body isn't functioning like it should and might not absorb enough otherwise.

At no time during my hospitalization did I get weighed so I don't know if this was a problem. I didn't have a problem with my hands or feet swelling.

Nancy, my experience was the opposite of Joe's. I was on a low sodium diet after my surgery, which made the typically bland hospital food taste even worse. I spoke with the nurses about the fact that I didn't need this diet and they said that everyone on the cardiac floor gets it, but I could speak with the dietician if I wanted. I decided it wasn't worth it and just asked my husband to bring me a disposable salt shaker. Mind you, I haven't added salt to my food in years, but I do cook with it. He also brought me a hamburger and french fries twice! Boy was that heaven! It just goes to show that sometimes hospitals have difficulty thinking of patients as individuals.

 

[Jkm7]

I was weighed as part of admittance. Then weighed frequently once I got to step down unit as the new beds in CCU at MGH are scales. They weighed the bed with blankets etc on it when I got up and then again when I got back in bed. Cool.
My hands were very puffy; not so much my ankles.

 

[ponygirlmom]

And right along with this is the very salty hospital diet. I did everything but hire a lawyer to try to get hospitals to provide Joe with a low sodium diet. Only one hospital even tried to help out, and that dietician was wonderful and caring.

This is so weird. Didn't hospital food used to be very bland? Didn't people used to complain about how plain it was?

Now it seems like hospital food is nothing but processed junk food.

Here's something mildly amusing to do in a hospital: When the dieticians call for your meal order, order a plate of steamed broccoli or some plain whole wheat toast. They get SO EXCITED. I only ate the hospital food the last two days I was there, but I wish I had started ordering it earlier, just to feel like I was making someone happy three times a day.

 

[Nancy]

At one of the hospitals, I tried to specify something off the menu for Joe. Guess what they served up--an empty plate, not once, but twice in a row.

You want to see someone go ballistic! I got the dietician in Joe's room immediately and reported the situation to the hospital administration.

 

[DebbyA]

The nurses told me that the terrible thirst after surgery is because they paint the inside of your mouth with something to prevent saliva, which could be inhaled during surgery. Even if you could drink pints of water, it wouldn't help the dry mouth until the substance wears off.

 

[Jkm7]

I think the less I know about all they do to us in the OR, the happier I'm going to be. If we ever knew all of it, none of us would submit.

 

[Scooby06]

Too much fluid

Too much fluid

Hey all,

If you are undergoing surgery "on-pump" then the system needs to be primed. If the surgeon didn't do this, then you would lose a massive amount of blood into the system before it was able to pump appropriatley. There has been quite a bit of research into this lately, and patients that have less IV prime in the circuit fare better after surgery (measured by requiring less tranfusions.)

If you are done "off pump" (beating heart CABG and the like.) you avoid the prime but...
Anesthesia uses fluids to deliver meds (open all of the time) and to help regulate your pressures.
I have seen patients get up to 8 liters in the or (2.2lbs per liter) but it is generally not a big deal, and it will shift and return to normal after a few days.

 

[dtread]

DebbyA, thank you for that answer that I believe is probably correct; i.e., that they probably painted my mouth with something to prevent me from salivating. That would explain why I had "dry mouth" the entire first day after surgery. It wasn't a thirst where it could be satisfied by drinking water. It was a need to sip water to keep my mouth moistened. I am sure that if they did paint my mouth with that stuff it would have been to prevent salivation so as to not block the airway. I had a sort of metallic or medicine-like taste in my mouth that first day also.

Scooby, thanks for your answer that I think answers why such a large quantity of fluid is required. So there is a need to increase blood volume when you go on the heart/lung bypass machine; so they give you extra IV fluid to do that. The rest of the weight gain is gained over the next day or so with the IV bags used for administering pain medication, antibiotics, etc. Too bad that they cannot limit the amount of IV fluid. I am sure the large volume of IV fluid contributed greatly to the general malaise I felt after surgery.

When I was in the Cardiovascular Recovery Room (CVRR) several hours after they pulled the breathing tube out they gave us some ice chips. Just a couple and I almost puked. You really cannot tolerate anything for quite a period of time in CVRR. A few hours later they gave us a sugar free popsicle. Was that great or what!! My mouth was so dry and that tasted so good. A little while later I was begging the nurse for another popsicle. We got our choice of grape or cherry. I'll never forget that. Simple pleasures.

The nurses in CVRR really deserve a LOT of thanks. They do a tremendous job and probably don't get all the kudos they ought to. The other nurses also deserve a LOT of thanks, but I think the CVRR nurses are really special.

 

[DebbyA]

About CVRR nurses: one of my first coherent thoughts there was "I'm going to remember these faces the rest of my life". But they were gone from memory in a week.