C.W. receives a total of 4 units of packed red blood cells (PRBCs), 5 units of fresh frozen plasma (FFP), and several liters of crystalloids to keep his mean BP above 60 mm Hg
On the second day in the MICU, his
total fluid intake is 8.498 L and output is 3.66 L. His hemodynamic parameters after fluid resuscitation are
pulmonary capillary wedge pressure (PCWP) 30 mm Hg and cardiac output (CO) 4.5 L/min.
Calculate his fluid balance and identify whether it is positive or negative.
Why will you want to monitor his fluid status very carefully?
His fluid balance is positive, 4.838 L. (Subtract the output, 3.66 L, from the total fluid intake of
8.498 L).
C.W. needs fluids and blood products to replace the lost blood volume, but because of his history
of HF, it would be easy to overload him with fluids and exacerbate his heart failure, resulting in
pulmonary edema.
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