الفهرس | Only 14 pages are availabe for public view |
Abstract Fluid is approximately 60% of body weight. Fluid is distributed between intracellular fluid and extracellular fluid. Intracelluar fluid contains majority of elementsm potassium, phosphorus, magnesium and protein. Extracellular fluid divided in to intravascular fluid (plasma) and interstitiall fluid. In our ICU its important to assess the patient if he need intra venous fluid or need fluid restriction. In critacully ill patient, Hypovolemia, Dehydration, Hypoperfusion, Blood Pressure and heat Rate must be recorded in initial assessment of patient in ICU to know need of urgent fluid resuscitation. In critically ill patient, time of giving fluids and type of fluids used is very important so it is usefull to know types of fluid s, characterstic of each one, Advantges, disadvantges physiology and pathophysiology of fluids. Fluid mamagement is essential line of treatment in many cases in ICU like septic shock, Diabetic Ketoacidosis, Burn, ALI, traumatic brain injury and bleeding following major trauma. In ARDS it is associated with septic state and hypovolemia so adapted fluid management has proven its prognostic value and fluid restriction can lead to organ dysfunction. In sever sepsis and septic shock patient develop tissue hypoperfusion and hypovolemia. initial fluid adminastrated untitl there is improvement in hemodynamic state. fluid adminstrated to increase cardic output and stroke volume. Dehydration has found in most cases of diabetic ketoacidosis so rapid fluid management is an essential line of treatment of patient with diabetic ketoacidosis. Fluid management in major burn injury is to maintain tissue psfusion in early phase of burn shock. the recommendations are to initiate fluid resuscitation when surface area burned is greater than 20%. Intra venous fluid (colloid and crystalloid) are main line of treatment in bleeding following major trauma until blood received and major bleeding has been stopped. Fluid management of sever traumatic brain injury is to maintain moderate hyper volemia (cvp=8-10mm hg).Negative fluid balance have adverse effect on outcome. |