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Una estrategia alternativa es reponer las pérdidas de agua diarias calculadas en orina, heces y pérdidas insensibles con solución salina hipotónica y no con agua sola, lo cual aporta un poco de sodio a los riñones para que ajusten la concentración.
Aunque no debe haber indicaciones médicas “sistemáticas” para líquidos de mantenimiento, estos dos métodos permiten el uso adecuado de glucosa al 5% en cloruro de sodio al 0.45% a razón de 100 ml/h como tratamiento inicial; se agrega potasio para los pacientes con función renal normal.
Sin embargo, muchos pacientes quirúrgicos tienen anomalías del volumen, electrolíticas, o ambas, relacionadas con su enfermedad quirúrgica.
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