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LETTERS:
Nicholas J Matheson, Sarosh R Irani, and Anushka Irani
Early intervention in acute renal failure: Evidence of inadequate intravenous fluid treatment in UK hospitals
BMJ 2006; 333: 551-a [Full text]
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[Read Rapid Response] Post-Operative Applicability
Toby P Fagan   (9 September 2006)

Post-Operative Applicability 9 September 2006
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Toby P Fagan,
FY1
St Johns Hospital, Livingston

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Re: Post-Operative Applicability

The authors make a good point about the importance of using U&Es for adjusting fluid prescriptions once blood results have become available for acute admissions, but I would be interested to know if the same applies to post-operative or ward based surgical patients. Having just worked for a week on a surgical HDU I would be very interested if anyone knows how quickly the urea:creatinine ratio changes in response to a changing volaemic state. Similarly, will the same rules apply to a patient receiving high dose analgesia (opiates or via an epidural etc) in whom it may be necessary to counter drug-induced vasodilatation with additional fluids?

Competing interests: None declared