Fluid Therapy: Overview and Types

Fluid Therapy: Overview and Types

1. Fluid Composition:

• Extracellular: primarily Na and Cl

• Intracellular: primarily K

• Infusion fluids: can move across cell membranes:

• Blood – interstitial – intracellular: water, urea

• Blood – interstitial: glucose

• Blood: protein

2. Types of Infusion Fluids:

• Fluid and electrolyte replacement:

• Crystalloid solutions:

• Classification:

• Isotonic: same concentration as body fluids, can be infused quickly, effective, few side effects, affordable.

• Hypertonic: higher concentration than body fluids, can draw fluid from cells into blood, but can cause cell dehydration and risk of edema.

• Hypotonic: lower concentration than body fluids, can draw fluid from blood into cells, but can cause edema.

• General advantages: rapid infusion, effectiveness, few side effects, affordability.

• General disadvantages: poor fluid retention, can cause edema.

• Plasma volume expanders:

• Colloid solutions: help retain fluid in blood vessels, enhancing circulation.

• Natural: serum, albumin

• Artificial: HES, polypeptides, polysaccharides

• General advantages: longer fluid retention, high efficacy.

• General disadvantages: can cause heart overload, allergies, high cost.

3. Specific Solution Types:

• Sodium chloride: cubic crystalline powder, odorless, salty taste, easily soluble in water.

• Potassium chloride: salty-bitter taste, contraindicated in patients with renal failure, diabetes.

• Calcium chloride: contraindicated in patients with arrhythmias, taking digitalis, hypercalcemia, combined with ceftriaxone causes precipitation.

• Ringer’s lactate: contraindicated in patients with metabolic alkalosis, severe heart failure, fluid retention, severe renal failure, bleeding disorders.

• Glucose: Dextrose

• Amino acid mixtures: Alvesin

• Dextran: high molecular weight solution for plasma volume replacement.

• Sodium bicarbonate: helps restore acid-base balance.

Note: Infusion fluids should be used only as prescribed by a physician, and patients’ health status must be closely monitored during fluid therapy.