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Post-Pneumonectomy Fluid Restriction — FRCA Final MCQ

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ModerateCardiothoracic AnaesthesiaPost-Pneumonectomy Fluid RestrictionFRCA Final

A 60-year-old man undergoes right pneumonectomy. Post-operatively in ICU, what IV fluid rate is appropriate?

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Correct answer: B — No IV fluids – oral only

Post-pneumonectomy, fluid management is RESTRICTIVE. The remaining lung is at high risk of pulmonary oedema from: (1) the entire cardiac output now passes through one lung's vascular bed, (2) surgical lymphatic disruption impairs fluid clearance, (3) inflammatory response increases permeability. Fluid restriction (typically 20-25 mL/kg/day total intake in the first 24-48 hours) significantly reduces post-pneumonectomy pulmonary oedema and mortality. Urine output may be low but should be tolerated if the patient is haemodynamically stable.

Reference: RCOA – 2023 – Cardiothoracic post-op care; ERS/ESTS – 2019 – Lung resection