Fluid Overload

Question 1

Definition?

Answer 1

Excess of fluid in the blood

Question 2

RF

Answer 2

• IV fluid bolus

Meds

Question 3

Aetiology?

Answer 3

Occurs due to aggressive fluid resuscitation, oliguria, and in sepsis due to ↑capillary permeability

Question 4

CP?

Answer 4

↑bp, ↑jvp, lung crepitations, peripheral oedema, gallop rhythm.

Question 5

Pathophysiology?

Answer 5

Volume overload generally refers to expansion of the extracellular fluid (ECF) volume. ECF volume expansion typically occurs in heart failure, kidney failure, nephrotic syndrome, and cirrhosis. Renal sodium retention leads to increased total body sodium content. This increase results in varying degrees of volume overload. Serum sodium concentration can be high, low, or normal in volume-overloaded patients (despite the increased total body sodium content). Treatment involves removal of excess fluid with diuretics or mechanical fluid removal via methods such as dialysis and paracentesis.

Question 6

I?

Answer 6

Vitals, FBC, serum electrolytes and urea, creatinine, serum/urine osmolality, ABG

Question 7

M?

Answer 7

Monitor weight daily in patients receivingivfluids.
• Oxygen supplementation if required.
• •Fluid restriction. Consider oral andivvolumes. Give antibiotics in minimal fluid and consider concentrated nutritional support preparations.
• •Diuretics. Only in symptomatic fluid overload. They are ineffective and potentially harmful if used to treat oliguria without fluid overload.
•Renal replacement therapyakiwith fluid overload and oligo/anuria needs urgent referral to renal/critical care.

Question 8

Prognosis?

Answer 8

• Good if taken off fluids quickly

Question 9

Complications?

Answer 9

• CHF
• Hyponatremia
Pulmonary oedema