Fluid Management 2015
Fluid Management 2015
FLUID BALANCE
BALANCE
AND
AND
FLUID
FLUID MANAGEMENT
MANAGEMENT
Dr Abdallah Hawari,MD, MRCSI
General and minimally invasive Surgeon
Head of endoscopic surgery , Al-Makassed hospital , Al-Quds
بسم هللا الرحمن الرحيم
>20kg20ml / kg
e.g:
Young patient weighted 70kg needs fluid as
follow :
(10*100) +(10*50)+(50*20)
1000 + 500 + 1000 = 2500ml
HOW TO CHOSE THE TYPE OF
FLUID
• The amount of fluid estimated as
mentioned
• To chose the type of fluid, this depend on
the body requirements of sodium and
energy.
• The daily sodium requirement is 2-3
meq/kg/day.
• If the 70kg man need 2500 ml , what is the
fluid type .
70*3=210 meq
Each 1 liter of NS contain 154 , so the
patient need nearly 1,5 L.
The rest of the fluid is chosen as free
water ( dextrose 5%), to avoid sodium
over load.
Patient with dehydration has
Hypovolemia.
This dehydration due to fluid loss that
associated with other electrolyte
abnormality and acid-base disturbances
that need correction.
The correction need to be rapid given as
expansion , if no limitation.
FLUID ADEQUACY
TYPES OF FLUID
COLLOID:
Blood & blood products
Albumin
Dextran
Starch
Glycerin
• CRYSTALOID:
Normal saline 0.9%, contain 154 meq Na/L & 154
meq Cl/L
Ringer lactat , contain 130 meq Na/L, 109 meq
Cl/L, 28 meq lactat/L.
M/6 sodium lactat , contain 167 meq Na, & 167
meq Cl
3% sodium chloride, contain , 513 meq Na, 513
meq Cl.
Dextrose saline , contain NS+ 50 gm glucose /L.
0.45% dextrose saline, contain 77 meq
Na/L , 77 meq Cl/L +50 gm glucose /L.
5% dextrose water
10% dextrose water
20% dextrose water
50% dextrose water
Electrolytes care
Potassium
Chloride
Magnesium
Calcium
Phosphorus
Trace elements
Trace Metal
1. Zinc 10-20 mg
2. Copper 0.5-2.0 mg
3. Chromium 20 μg
4. Selenium 70-150 μg
5. Manganese 2-2.5 mg
6. Iron 25 mg
SHOCK
Definition :
Tissue hypo perfusion that is
in sufficient to maintain normal aerobic
metabolism
MICRCIRCULATION
CHANGES
ECS
Transcapillary influx
To chose suitable fluid you need fluid
that compensate both the IV & IS
deficit.
UO N OLIGURIA ANURIA