Basic science of fluid therapy

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Principals of fluids and electrolytes management

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Presentation transcript:

Basic science of fluid therapy Robert Hahn, MD, PhD Research Director, Södertälje sjukhus Adj. Professor of Anaesthesia & Intensive Care, Karolinska institutet Malmö 2017 1

Conclusions, Crystalloids Volume kinetics is pharmacokinetics of infusion fluids. Distribution of crystalloid fluid requires 30 min to be completed, both in conscious and anesthetized patients. Distribution is temporarily arrested during induction of anesthesia. This is due to the reduction of MAP. Urinary excretion is very low during general anesthesia. Recent data suggest a direct dependence on MAP and (inversely) on age.

Conclusions, Colloids Colloids have no distribution phase, but an intravacsuar persistence half-life of 2-3 hours. Colloid fluid kinetics is probably not affected by MAP. Crystalloid fluid infused after a colloid will be poorly excreted and aggravate peripheral edema. Colloid fluid may promote diuresis during surgery, but acts to retain fluid during the postoperative phase.