Fluid Therapy
Fluid Therapy
Fluid Therapy
Electrolytes
CME
Contents
1. Total body water and body water compartment
2. Principle of intravenous fluid therapy
3. Clinical assessment + fluid therapy concept
4. Types of fluid
a. Crystalloid: Normal saline,Hypotonic, Hypertonic, Dextrose solution, Ringer’s Lactate,
Hartmann’s
b. Colloid
6. Perioperative fluid
7. Blood products
Indication of Intravenous Fluid Therapy
● Resuscitation
● Routine maintainance
● Replacement
● Redistribution
1) Fluid Resuscitation
Usually urgent, aims to restore circulation to vital organs following loss of volume
either by bleeding, plasma loss, GI loss of external fluid and electrolyte loss or
severe internal loss eg. fluid redistribution in sepsis
2) Routine maintanence
Required for patient whoever cannot meet their normal fluid or electrolyte via
enteral fluid, otherwise well in term of fluid and electrolyte balance. Eg. they
are usually euvolaemic with no significant deficit or ongoing blood or fluid
loss.
3) Replacement
For patients with ongoing GI/urinary tract loss, fever or burns (plassma loss) as
well as insensible fluid loss in which daily fluid requirement cannot be met
without IV fluid.
4) Redistribution
Hx: limited intake, thirst, the quantity and composition of abnormal losses
Clinical examination :
Routine Maintenance
This will increase fluid volume in both the interstitial and intravascular
* Isotonic
* Hypotonic
* Hypertonic
Types of isotonic solutions include:
Contraindications:
CI
Heat-treated preparations of human serum albumin are commercially available in a 5% solution (50 g/L)
and a 25% solution (250 g/L) in an isotonic saline diluent.
Features
Approximately half of the infused volume of 5% albumin stays in the vascular space. last 12 to 24 hours.
Disadvantages
❖ Synthetic colloid
❖ Starch molecules are derived from plants. Advantages:
-Less expensive compa
❖ Smaller starch molecules eliminated by kidney, large molecule -Nonantigenic, rare an
will be broken down by amylase first. reaction.
-No significant effect t
coagulation studies an
•Indication: time.
● Volume expander in treatment and prophylaxis of hypovolemia.
● Administer up to 50 mL/kg/day (equivalent to 3 g hydroxyethyl
starch and 7.7 mEq Na per kg of body weight).
Side effects:
• This dose is equivalent to 1. Pruritus
3500 mL for a 70 kg patient 2. Increased serum amylase
Give initial 10-20 mL by slow 3. Decreased coagulation factors
IV infusion n HCT
4. AKI
Gelofusine
Indication: