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Principles of Fluid Therapy (view source)
Revision as of 20:59, 12 April 2009
, 20:59, 12 April 2009no edit summary
#Colloids
#Colloids
#Blood Products
#Blood Products
If there is an electrolyte imbalance present then it may be necessary to add the appropriate electrolyte solution.
==Fluid Rate Calculations==
==Fluid Rate Calculations==
These calculations are then added together to allow for the total fluid requirement in a 24 hour period. It is important to assess these requirements on a daily basis as losses may be increased/reduceed for example.
These calculations are then added together to allow for the total fluid requirement in a 24 hour period. It is important to assess these requirements on a daily basis as losses may be increased/reduceed for example.
The calculated fluid requirement is multiplied by the bodyweight of the individual patient to give the total amount of fluid required for that patient as ml/24hr period. This is then further calculated depending on whether a ddrip pump is used or fluid rate is adjusted manually as shown below.
The calculated fluid requirement is multiplied by the bodyweight of the individual patient to give the total amount of fluid required for that patient as ml/24hr period. This is then further calculated depending on whether a ddrip pump is used or fluid rate is adjusted manually as shown below.
===Anaesthesia===
===Anaesthesia===
====Pre-anaesthetic====
====Pre-anaesthetic====
Before an anaesthestic is performed, it is important to stabilise a patient, both fluid deficits and any electrolyte or acid-base inbalances. In many cases, it is ideal to have a minimum blood database. This should include Packed Cell Volume (PCV) and Total Protein (TP) and if possible urea, creatinine, electrolyes and glucose. If there is any evidence of haemoconcentration, azotemia, or electrolyte imbalances then the patient should be given fluids to correct these abnormalities before the anaesthetic. When giving fluids ideally they should be warmed to help the patient maintain a normal body temperature.
====Intra-anaesthetic====
====Intra-anaesthetic====
During an anaesthetic, glucose levels should be closely monitored, especially patients with diabetes, liver disease or paediatric patients. If necessary it is then possible to add glucose or dextrose to the fluid the patient is receiving.
Some patients may develop an anaesthetic-induced hypotension from the side-effects of the agents used to induce and maintain anaesthesia. Fluids are therefore often given as a preventative measure.
If there is significant blood loss during a procedure, it is necessary to replace these losses, either using blood products or an appropriate fluid.
====Post-anaesthetic====
====Post-anaesthetic====
If a patient has been receiving fluids during a procedure, it is often continued after until the patient is either stable and fully recovered from the anaesthetic. The length of time the fluids continue for after the procedure is dependent on the individual patient and the individual case.
===Cardiac===
===Cardiac===
It is important to avoid fluid overload in cardiac patients who often have reduced cardiac function.
===Central Nervous System===
===Central Nervous System===
Patients with head trama or increased intracranial pressure are particularly suscetible to insufficient or excessive fluid loading. It is therefore with care that fluids are administered and monitored. The choice of fluid is dependent on the other clinical signs of the patient such as haemodynamics. The status of the blood brain barrier is an important consideration in any patient and in the selection of fluid. However, fluids containing glucose should be avoided in these patients.