Surgery fluids and electrolytes

Apr 15th, 2015
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FLUIDS &ELECTROLYTES IN SURGERY*** ***DR. MUGENYAFluid And ElectrolytesTherapyThough fluid and electrolyte therapy canbe a lifesaver, it can also be very harmful. Fluid and electrolyte balance is anextremely complicated thing. It requires the understanding of itscomposition and distribution in the body.Fluids & ElectrolytesTotal body water: 60% of total body weight in males. 55% of total body weight in females. 75% of total body weight in infants.Total Body WaterTotalBodyWaterIntracellular 2/3Extracelular 1/3Intravascular1/3Interstitial2/3Total Body Water% Body Weight% Total BodyWaterBody WaterICFECF--Intravascular--Interstitial6040201006733416825Water Sources & LossesSourcesooExogenous 2 3 litres per dayEndogenous ( metabolic water )350 ml/dayLossesooSensible:- urine & faeces(1000 ml/day and100- 200 ml/day)Insensible:- sweat & respiration (500 1000ml/day)NB: Water input should be = Water outputElectrolytes Metabolism Na :- Main extracellular cation =>135 -145 mEq/lo Daily requirements is about 5 gm.o Equivalent to 5oo ml of isotonic saline 0.9 % K :- Main intracellular cation => 3.5 -5.5 mmol/lo A normal daily intake 1mmol/kg Ca:-Normal total serum level is 8.5 -10.5 mg/dlo Normal ionized serum level is 3.5 -4.5mg/dlo Hypoalbuminemia causes totalhypocalcaemia without affecting thephysiologically active ionized Ca.Perioperative F

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