Fluid Balance Flashcards
What are the signs of hypovolaemia?
Decreased BP, reduced urine volume, non-visible JVP, poor tissue turgor, increased pulse, daily weight loss
What are the signs of fluid overload?
Increased BP, increased JVP, lung creps, peripheral oedema, gallop rhythm (S3 gallop)
How is hypovolaemia managed?
1) 500mL Crystalloid over 15 mins
2) Reassess fluid state
3) Further boluses of 250-500mL crystalloid, with clinical review after each
4) Stop when euvolaemic or seek expert help when 2L given
What crystalloids can be used?
Follow local guideline
Usually, balanced or buffered crystalloids include Hartmann’s, Ringer’s lactate, and Plasma-Lyte®
How is hypervolaemia managed?
1) O2 supplementation if required
2) Fluid restriction
3) Diuretics - if symptomatic
4) RRT - AKI + oligo/anuria
What is the routine maintenance of IV fluids?
- 25-30 ml/kg/day water + 500ml for insatiable losses
- 1mmol/kg/day Na+, K+, Cl-
- 50-100g/day glucose (e.g. glucose 5% contains 5g/100ml
How much K+ can be given?
No more than 10mmol/hr due to effects on heart