Treatment with intravenous fluids in adults
Transcription
Treatment with intravenous fluids in adults
Treatment with intravenous fluids in adults Errors in the handling of liquids are common and have been attributed to inadequate training and knowledge. The intravenous management of fluids is a common medical practice and the result of the training of physicians in training must be their precise prescription, unambiguously. However, errors in the handling of liquids are common and have been attributed to inadequate training and knowledge. Poor fluid management can have serious consequences, such as lung edema and severe hyponatremia resulting from excessive fluid administration and acute renal failure caused by insufficient fluid administration. What is the best way to prescribe intravenous fluids? There is a lack of good quality evidence, such as that provided by controlled and randomized studies, to guide the management of intravenous fluids by IV Hydration In Boston. The safe prescription of intravenous fluids requires the integration of important clinical skills, such as knowledge of the balance of fluids, the physiology of fluids in both normal and pathological conditions and the properties of intravenous fluids commonly used. Normal liquid balance Water constitutes about 60% of the total body weight in men and 55% in women (women have a slightly higher content). Although the distribution of body water is not uniform, it can be considered that it occupies the intra and extracellular compartments. The extracellular fluid is composed mainly of plasma and interstitial fluid, which are separated by the capillary membrane. Movement of water between the plasma and the interstitial space The capillary endothelium is coated by the glycocalyx, a network of proteoglycans and glycoprotein’s that separate the plasma from the subglycalic space. The movement of the fluid through the capillaries is determined by the difference in transendothelial pressures and the difference in colloid tic pressure between the plasma and the subglycalic space. As a result, most of the fluid filtered from the plasma through the non-fenestrated capillaries returns to the circulation in the form of lymph, through the interstitial lymphatics. Movement of water between the interstitial and intracellular spaces This Iv Hydration Boston is mainly determined by osmotic forces. The water balance is regulated by the ant diuretic hormone-thirst feedback mechanism, which is influenced by osmoreceptors and bar receptors. The normal hydro electrolytic balance can be greatly altered by disease and injury, depending on non-specific metabolic responses to stress, inflammation, malnutrition, medical treatment and organ dysfunction. For example: Response to stress: during the catabolic phase of this response potassium is lost and sodium and water are retained, resulting in oliguria. Therefore, after surgery, it is important to differentiate the oliguria caused by the (inoffensive) stress response of oliguria caused by acute renal failure. Inflammatory conditions (e.g., sepsis or after trauma or surgery) and other medical conditions (diabetes, hyperglycemia, hypervolemia) that degrade the endothelial glycocalyx and reduce its barrier function. Thus, infused colloids can leave the intravascular space to the compartment of the interstitial fluid, reducing its volume-expanding effect and contributing to interstitial edema. Malnutrition: can lead to overload of sodium and water and depletion of potassium, phosphate and magnesium. In malnourished patients, intravenous glucose can precipitate pulmonary edema and cardiac arrhythmias.