Intravenous Fluid Therapy Flashcards
What is the difference between maintenance and resuscitative fluid therapy?
Maintenance: replace the routine losses and provide nutritional support
Resuscitation: replace lost fluid to restore an effective circulating volume
What is the total body water (TBW) in a 70kg male
Define ICF and ECF in proportion to the TBW. Also, define what compartments make up the ECF
TBW: 60% = 42 L ICF = 28L ECF = 14 L - Interstitium = 10 ,5 L - Plasma = 3 L - Transcellular = 0.5 L (synovial joints and CSF)
TBW = ICF + ECF
What is the major difference in composition between the plasma and the interstitium?
The protein content 15 in plasma versus < 0.1 in interstitium.
How does the composition of the ECF compare to the ICF
ICF Less sodium More potassium Less calcium More Magnesium Less chloride Less HCO3 MORE protein More phosphates
What are the average insensible losses that occur and where do they occur
Skin: 500 ml/24 hr
Lungs: 300 ml/24 hr
What are the average measured losses that occur and where do they occur
Urine: 500 - 1200 ml/24 hr
Faeces: 500 ml/24 hr
What is the average range for total fluid loss (measured + insensible) in a 24 hour period
Skin 500
lungs 300
urine 500 - 1200
faeces 500
Total: 1800 - 2500
Which of the following will lead to increased insensible losses A. Epilepsy B. Vomiting C. Pyrexia D. Diuretics E. Burns F. Diarrhoea G. Diabetic
C, E, G
How are maintenance fluids calculated?
4ml/kg/hour - 1st 10 kg \+ 2ml/kg/hour - 2nd 10 kg \+ 1 ml/kg/hour - for every kg over 20kg
70 kg male
10kg x 4ml/kg/hour =40 ml/hr \+ 10 kg x 2 ml/kg/hour = 20 ml/hr \+ 50 kg x 1 ml/kg/hr = 50 ml/hr
110 ml/hour
How does diffusion across the cell membrane differ from diffusion between plasma and interstitium
Electrolytes can’t readily cross the cell membrane
Electrolytes can readily move between the plasma and the interstitium. Proteins and other Large molecules cannot. The oncotic pressure generated by these proteins within the plasma minimizes net fluid loss from plasma.
Define gelatin
a virtually colourless and tasteless water-soluble protein prepared from collagen
What is the required daily electrolyte requirements for NA and K
Na - 1 - 2 mmol/kg/24 hr
K - 0.5 -1 mmol/kg/24 hr
What is the composition of Plasma, Interstitium, IC fluid
Na/K/Ca/Mg/Cl/HCO3/Protein/PO4
Na/K/Ca/Mg/Cl/HCO3/Protein/PO4
Plasma
140/4.2/2.4/1.1/112/25/15/8.1
Interstitium
145/4/2.4/1/117/27/0.1/8.7
ICF
10/157/1.0/40/7/45/154
