Chiarra D.

Sian
BMLS-3
 Principal electrolyte :
Extracellular fluid (ECF) - Sodium ion (Na+)
Intracellular fluid (ICF) Potassium ion (K+)

Other important electrolytes:

*Calcium
*Magnesium
*Phosphorus

Fluid balance- is controlled by renin-angiotensin-aldosterone

system
-Antidiuretic hormone system
-Sympathetic hormone system
 60% of the body is water.
It is referred to as TOTAL BODY WATER (TBW).
Distribution:
*ICF 67%
*ISF 25%
*Plasma volume 8%

Intravascular Fluid (IVF) fluid inside the blood vessels

Extravascular Fluid (EVF) fluid outside the blood vessels.
e.g. lymph and CSF

Plasma straw colored component of lymph that contains

leukocytes,erythrocytes and platelets.
Serum- clear cell-free portion of blood .
Interstitial fluid- fluid found in spaces between cells , tissues and organs.
 Are fluids given by intravenous injection supply water and
sodium to maintain the osmotic gradient between the
extravascular and intravascular compartments.

Normal Saline Solution (NS 0.9% NaCl)

Lactated Ringers Solution

Crystalloid solution are maintenance fluids.

Used to compensate fluid losses and replacement of fluid deficits.
 Benefits of crystalloid administration:

1. Promotes urinary flow

2. Less expensive than colloid and blood products.
3.No risk of vital transmissin and anaphalyxis
4.No alteration in the coagulation profile associated with its use
unlike in the blood products.

Common indication of either crystalloid and colloid

replacement therapy:

*Acute liver failure

*Acute nephrosis
*Adult respiratory distress syndrome
*Burns
*Cardiopulmonary bypass
*Hypoproteinemia
*Shock
 Contraindications:
1. Allergies to a specific products
2.Hypervolemia
3.Severe electrolyte imbalance

Adverse effects:
Crystalloids do not contain large particles, they do not stay
within the blood vessels and may leak out of the plasma into
the tissues and cells.

Peripheral or pulmonary edema- due to osmosis.

*Short lived effects
 - protein substances that increases the COP (colloid
oncotic pressure), effectively moving fluid from the
interstitial compartment to the plasma compartment by
pulling the fluid into the blood vessels.
This is accomplished by proteins( albumin,globulin and
fibrinogen)
Total protein level must be in 7.4 g/dL
If this level drops to 5.3 g/dL ,colloid replacement
therapy is indicated.

COP decrease by age, hypotension and malnutrition.

Contraindications:
1. Allergies to a specific products

2.Hypervolemia

3. Severe electrolyte disturbance

Adverse effects:
Colloids have no oxygen transporting capabilities
and clotting factors, so they can alter the coagulation
system by dilution.
Results in impaired coagulation and bleeding.

**Dextran may cause anaphylaxis or renal failure,

but is rare.
Drug interaction:
Colloid solutions are compatible with many
medications and may be used as vehicle for
delivering drugs
. Example is propofol.

Most commonly used colloids:

5% Albumin Dextran 40 and Hetastarch
characterized by quick onset and long
duration of action.
 They are most expensive and the least available of the three
groups of fluid replacement agents because they are natural
products that requires human donor.

E.g: Whole blood, cryoprecipitate, fresh frozen plasma,

packed red blood cells, plasma protein fraction.

Red blood cells have the ability to carry oxygen. They

maintain the COP for several hours to days.

Indications:
Blood products are indicated when patients body is deficient in these
products.