KRISTALOID DAN KOLOID

Kelompok 5
Kepaniteraan Klinik lmu Kesehatan Anak
Periode 8 November 2010 – 8 Januari 2010
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RESUSITASI MAINTENANCE

Kristaloid
Koloid Nutrisi
Elektrolit
130 Ringer Asetat Albumin 77 KAEN 1B Amiparen
(Asering) Dextran 50 KAEN 3A Aminovel 600
Gelatin 38 KAEN 3B Pan-amin G
130 RL
HES KOREKSI 30 KAEN 4A/4B PAED KAEN MG3
154 NS
Triparen
Mengganti kehilangan 1. Kebutuhan normal
akut (hemorrhage, (IWL + urin+ feses)
GI loss, rongga ke3) 2. Dukungan nutrisi
 Isotonic infusion
• Ringer’s acetate
1 L of • Ringer’s lactate
• Normal saline

Mengganti
kehilangan
Meningkatkan ECF
cairan akut

ICF
ICF ISF
ISF Plasma
Plasma

800
800 ml 200
200 ml
 Hypotonic infusion

1 L of 5% dextrose

Menggantikan
kehilangan
kehilangan
Meningkatkan ICF > ECF cairan
cairan normal
normal
(IWL
(IWL ++ urine)
urine)

ICF
ICF ISF
ISF Plasma
Plasma

660 ml 255 ml 85 ml
 Albumin infusion

500 ml L of Albumin 5%

Hemorrhagic
Hemorrhagic shock
increases intravascular Burn
Burn

ICF
ICF ISF
ISF Plasma
Plasma

250-750 ml
 Albumin infusion

100 ml L of Albumin 25%

Hemorrhagic
Hemorrhagic shock
shock
increases intravascular Burn
Burn
Reserved
Reserved for
for patients
patients
in
in whom
whom ISF
ISF expanded
expanded
but
but intravascular
intravascular and
and
albumin
albumin is
is severely
severely
depleted
depleted
ICF
ICF ISF
ISF Plasma
Plasma

300-600 ml over 30-60 min

min
Ref. Evan R. Geller. Shock & Resuscitation. McGraw Hill, 1993. p 221
 Plasma Expander infusion
500 m L of Dextran
HES

increases intravascular Hemorrhagic shock

ICF
ICF ISF
ISF Plasma
Plasma

750 ml at 1 hour; 1050 ml at 2 hr

Ref. Evan R. Geller. Shock & Resuscitation. McGraw Hill, 1993. p 225
 KEUNGGULAN
KOLOID KRISTALOID
1. Molekul besar 1. Kecil (Na+,K+,Gluk,Dext)
2. Tidak larut sempurna 2. Larut sempurna
3. Mikroemboli 3. Membuat sumbatan
4. Tahan 4-6 jam dalam 4. Tahan 2-3 jam dalam
IV IV
5. Cepat me↑ sirkulasi 5. Lambat
6. Protein Mahal 6. Elektrolit/ karbohidrat
7. Jml koloid ~ vol darah 7. Murah
hilang 8. Jml kristaloid 3-4x vol
darah hilang
 KEKURANGAN
KOLOID KRISTALOID
1. Anafilaksis 1. Edema 
2. Koagulopati ekspansibilitas dinding
3. Albumin bisa dada ↓
memperberat depresi 2. Jarak kapiler-sel
miokard pada pasien bertambah 
syok oksigenasi jaringan
terganggu
3. Memerlukan volume
4X lebih banyak