Download presentation
Presentation is loading. Please wait.
1
FLUID AND ELECTROLYTE BALANCE
Prof. ÖZCAN GÖKÇE, MD Director of the Department of General Surgery Yeditepe University Hospital
2
Chemical and biologic activities of fluid
Total particle count in per unit volume of solution (mmol/L) Electrically active particles in per unit volume of solution (mEql/L) Osmotically active particles in per unit volume of solution (mO/L)
3
Osmolality is a measure of the osmoles of solute per kilogram of solvent (osmol/kg) The osmole (Osm or osmol) is a non-SI unit of measurement that defines the number of moles of a chemical compound that contribute to a solution's osmotic pressure. Osmolarity is the measure of solute concentration (osmol/L)
5
Every increase 100 mg/dl glucose 1,6-3 meq/L Na+ decrease
6
Henderson-Hasselbach equation
8
pCO2= 37-42 mm Hg HCO3- = 22-28 meq/L
pH=7.34-7,44
21
P50 it is common to use the concept of P50 to describe the affinity of a given hemoglobin for oxygen. The P50 is the PO2 at which the hemoglobin becomes 50% saturated with oxygen. As the P50 decreases, oxygen affinity increases and visa versa. Normal adult Hemoglobin A has a P50 of 26.5 mm Hg while Fetal Hemoglobin F has a P50 of 20 mm Hg and sickle cell anemia Hemoglobin S has a P50 of 34 mm Hg.
24
B C A A<B<C (a – v) O2
26
Anionic gap Measured cathions = Na,K Measured anions= HCO3- , Cl-
27
Anionic gap = Unmeasured anions-Unmeasured cathions
Na+K + Unmeasured cathions = HCO3- + Cl- + Unmeasured anions Anionic gap = Na+K - ( HCO3- + Cl- ) Anionic gap = ( ) Anionic gap = 12 Meq/L Correcred anionic gap = Actual anionic gap - {2,5(4,5-Albumin)}
34
FLUID REPLACEMENT
35
PRACTICAL ISSUES 1 Protein intake increases urea(Urine) and causes osmotic diuresis. 1gr protein needs 7 ml water
36
PRACTICAL ISSUES 2 Treatment of Hypernatremia
%5 dextroz, CVP and control of electrolytes
37
PRACTICAL ISSUES 3 Treatment of Hyponatremia 135 - Na mEq/lt = A
A*0,5*Body weight = B %3 NaCl……518 mEq/lt B*1000 = C C/2….in 2 hours C/2….in other 6 hours
38
PRACTICAL ISSUES 4 Treatment of Acidosis 15-CO2 mEq/lt = A
A*0,3*Body weight = B B*1000 = C (1/6 M Lactate) C/2….in 2 hours C/2….in other 6 hours B*1000 = C (1/6 M NaHCO3) 178
39
PRACTICAL ISSUES 5 Treatment of Hypopotasemia 3,5 - K mEq/lt = A
A*0,2*Body weight = B B is not given more than 40mEq/hour 40mEq/liter Blood K should be measured every 2 hs K solutions contains 1 mEq/cc
40
PRACTICAL ISSUES 6 Daily Na requirement is 2-4 mEq/kg
Daily K requirement is Na/2 mEq/kg
41
THE END
Similar presentations
© 2025 SlidePlayer.com. Inc.
All rights reserved.