What is the estimated intraoperative fluid loss for a severe bowel resection?

• A. 4-6 ml/kg/hr
• B. 6-8 ml/kg/hr
• C. 8-10 ml/kg/hr
• D. 10-12 ml/kg/hr

Answer: (B)

Intraoperative fluid management for major abdominal surgery relies on replacing ongoing losses from third-space shifts and maintaining tissue perfusion. For a severe bowel resection, the expected rate to replace these losses is about 6–8 ml per kilogram per hour. This helps keep perfusion adequate without overshooting and causing edema or fluid overload.

For example, a 70 kg patient would typically receive roughly 420–560 ml of crystalloids per hour at this baseline rate. If there’s significant blood loss, hypotension, or other factors increasing losses, the rate may be adjusted upward or supplemented with blood products, but the standard starting target for this scenario is 6–8 ml/kg/hr.

So, the best fit is the middle range that reflects substantial intraoperative losses without the extremes used for massive trauma or burns. Lower rates would risk hypoperfusion in a severe resection, while higher rates would raise the risk of fluid overload in a typical case.