🎙️ Surgery - EP3: Fluid Balance and Replacement
Welcome to another episode of the MedSimu Surgery Podcast, where we break down surgical fundamentals for clinical excellence and exam prep. Today’s focus is fluid balance—a vital concept in both acute and routine surgical care.

🎧 Tune in to Learn:
✅ Fluid Compartments – ICF vs. ECF, and the 60/40/20 rule
✅ Monitoring – Clinical signs, urine output, daily weight, U&E
✅ Causes of Imbalance – Third spacing, surgery, kidney disease, iatrogenic errors
✅ Fluid Resuscitation – Shock criteria and emergency bolus strategy
✅ Maintenance Fluids – 25–30 mL/kg/day and the 100-50-20 rule explained
✅ Replacement Therapy – Calculating deficits, matching ongoing losses, adjusting for intake
✅ Electrolytes – Safe correction of sodium, potassium, and the role of labs

Chapters

• (00:00) - Intro & Overview
• (00:44) - What Is Fluid Balance?
• (01:06) - Fluid Compartments: ICF vs. ECF
• (01:28) - Electrolyte Movement & Homeostasis
• (01:38) - Why Monitoring Fluid Status Matters
• (02:16) - Signs of Dehydration & Overload
• (03:06) - Urine Output & Daily Weights
• (03:42) - Lab Investigations: U&Es, HCT
• (04:13) - Causes of Imbalance in Surgical Patients
• (05:14) - Emergency Resuscitation Criteria
• (05:39) - Fluid Bolus & Initial Steps
• (06:14) - Maintenance Therapy: When & How Much
• (06:44) - Maintenance Calculations: 100-50-20 Rule
• (07:15) - Fluid Replacement for Ongoing Losses
• (07:59) - Electrolyte Correction & Monitoring
• (08:19) - Final Recap & Takeaways

Whether you’re managing NBM patients, resuscitating trauma, or preparing for MRCS and surgical rotations, this episode will give you the clinical clarity you need.

🔔 Subscribe to the MedSimu Surgery Podcast for more essential breakdowns on surgical care!
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