Fluids Flashcards
fluid types (4)
you need 30ml/kg per hr
1mmol/kg/24hr (Na and K) forget about Cl for simplicity sake
50-100g glucose in 24hr
Na replacement can be less exact but K replacement needs to be exact - dont replace K faster than 10mmol/h
1 options if K is low for replacement
1. potassium chloride 0.3% (40mmol) minimum 4h
2. potassium chloride 0.15% (20mmol) minimum 2hr
note the potassium doesn’t come on its own - it is mixed - sodium chloride 0.9%/potassium chloride 0.3% 1000ml, or glucose 5% / potassium chloride 0.15% 1000ml
emergency resus fluid
500mL 0.9% saline 15minutes
emergency hypoglycaemia fluid
100mL glucose 20% 15 minutes
emergency hypokalaemia fluid
sodium chloride 0.9% potassium chloride 0.3% 1000mL 4hr
emergency hypercalcaemia
sodium chloride 0.9% 1000ml 4hr
maintanance fluids without deficits or losses
25-30mL / kg / 24hr water
1mmol/kg/24hr (Na and K) forget about Cl for simplicity sake
50-100g glucose in 24hr
aim for around 1000mL in 8-12hr
maintenance fluids WITH deficits or losses i.e., Na, K, diarrhoea vomitting
So when you give maintenance for fluid losses you are giving maintenance and replacement but this does not mean give your standard 2/2.5L maintenance + more fluid for losses, you are saying my maintenance will account for losses, so instead of doing 30ml//kg/hr , if you have their weight or urine output/losses you use this to work out their maintenance amount (mL) and then you hypothesise about electrolyte needs based off how much electrolytes are lost via each route (i.e., NG tube lots of Na and K and Cl)
Plus replacement you might want to give a bit faster
why dont you give dextrose for resus? And why are colloids often reserved for after the acute phase/what is worrying about giving them acutely.
if vessels are leaky the albumin will leak out and make cellular oedema worse
when to avoid dextrose?
brain injury - causes oedema
risks of colloids
anaphylaxis and AKI
