Rehidrasi
Pemberian cairan rumatan
Akses pemberian obat
I. PHYSIOLOGY
TOTAL BODY FLUID
INTRACELLULAR
INTRACELLULAR
FLUID(ICF)
(ICF)
FLUID
30 40 % BW
EXTRACELLULAR
FLUID (ECF)
INTRAVASCULAR
INTRAVASCULAR
FLUID
FLUID
5%
BW
TRANSCELLULAR
TRANSCELLULAR
FLUID
FLUID
1-3 % BW
INTERSTITIIL
INTERSTITIIL
FLUID
FLUID
15 % BW
Extracellular
fluid: 20 % BW
lungs
intestines
Blood plasma: 5% BW
Interstitiil fluid: 15 % BW
Intracellular fluid: 40 % BW
skin
kidney
Cairan Kristaloid
INTRAVENOUS FLUIDS
A. CRYSTALLOIDS:
- COMPOSITION: SIMILAR TO EXTRACELLULAR FLUID
- INEXPENSIVE, AVAILABLE, NO CROSS MATCH, NO
ALLERGIC / ANAPHILACTIC REACTION, SIMPLE
STORAGE
- AS EFFECTIVE AS COLLOID IN APPROPIATE AMOUNT
- HALF LIFE IN INTRAVASCULAR SPACE: 20 30
MINUTES
2.
Cairan Koloid
3.
B. COLLOIDS
- NATURAL COLLOIDS:
-PLASMA PROTEIN FRACTION 5%
-HUMAN ALBUMIN 5% AND 2,5%
- SYNTHETIC COLLOIDS
- DEXTRAN 40 AND 70
- HYDROXYETHYL STARCH (HETASTARCH) 6%
AND
10 %
-GELATIN
-MODIFIED FLUID GELATIN
-UREA LINKED GELATIN
-OXYPOLY GELATIN
Distribusi Cairan IV
Larutan
Plasma Interstitial
Albumin
1000 Polygeline
700
300
Dextran 40 1600
-260
NaCl 0,9% 200
800
RL
200
800
Dektrose5% 83
333
Intrasel
-340
583
CRYSTALLOID VS COLLOID
Crystalloid
Colloid
Advantages
- Inexpensive
- Promotes
urinary flow
- Fluid of choice
for initial
resuscitation of
trauma/hemorrh
age
- Expands
intravascular
volume
- Restores 3rd
spaces losses
Disadvantage
s
- Dilutes colloid
osmotic pressure
- Promotes
peripheral
oedem
- Higher
incidence of
pulmpnary
oedem
- Requires large
volume
- Effects are
Expensive
-May produce coagulopathy (dextrans
and hetastarch)
-With capillary leaks may potentiate
fluid loss to the interstitium
-Impairs subsequent crossmatching of
blood (dextran)
-Dilutes clotting factors and platelet
-Decrease platelet adhesiveness
(absorption onto platelet membrane
reseptor)
-Potential blocking of renal tubules and
Terapi Cairan
Resusitasi
Kristaloid
Koloid
Rumatan
Elektrolit
Nutrisi