Intravenous fluid therapy, Resuscitation, Fluid and electrolyte levels in the body, intracellular and extracellular compartments, IV fluid therapy is used to maintain homeostasis, Resuscitation, Routine maintenance, Replacement, Redistribution and Reassessment.

1. KAMAL CHANDRA UPRETI
kammph@gmail.com

2. Water is an essential element for life. Right throughout human history water
has been looked on as something intertwined with humankind. Human
beings live alongside water and are nourished by water. It is a source of
beauty, wonder and relaxation and refreshment.
Water is a primary building block of life. Without water
there is no life.

3. Homeostasis or homoeostasis (homeo- + -stasis) is the property of a system in
which variables are regulated so that internal conditions remain stable and
relatively constant. Examples of homeostasis include the regulation of
temperature and the balance between acidity and alkalinity (pH).
It is a process that maintains the stability of the human body's internal
environment in response to changes in external conditions.

4. List of systems of the human body

6. Integumentary System
Forms external body covering and protects deeper tissue from injury e.g. hair, skin
& nails.
Muscular System
Allows manipulation of the environment, locomotion, and facial expression.
Maintains posture & produces heat.
Skeletal System
Protects and supports body organs, and provides a framework the muscles use to
cause movement. Blood cells are formed within bones.
Nervous System
Fast acting control system of the body, it responds to internal and external
changes by activating appropriate muscles and glands. Brain, nerves & spinal cord.
Cardiovascular System
Blood vessels transport blood, which carries oxygen, carbon dioxide, nutrients,
wastes, etc. The heart pumps blood.

7. Digestive System
Breaks down food into absorbable units that enter the blood for distribution to blood cells.
Respiratory System
Keeps blood constantly supplied with oxygen and removes carbon dioxide
Urinary System
Eliminates nitrogenous wastes from the body.
Endocrine System
Glands secrete hormones that regulate processes such as growth, reproduction, and nutrient
use by body cells. Glands e.g. adrenal gland, pineal gland, ovary.
Lymphatic System
Picks up fluid leaked from blood vessels and returns it to blood. Disposes of debris in the
lymphatic stream. Houses white blood cells involved in immunity.
Reproductive System
Overall function is the production of offspring.

9. Basic requirements of human cell

10. TOTAL BODY WATER
 Total body water content-
60% of body weight (young adult male)
50% of body weight (young adult female)

11. Intracellular Volume
Extracellular Volume
Interstitial Volume
Plasma Volume
Total Body Water 60% 42L
40% 28L
20% 14L
15% 10.5L
5% 3.5L

14. Minimal Daily water output:
500mL : Urine
500mL: Skin
400mL: Respiratory tract
200mL: Stool
TOTAL : 1600mL
On average, an adult input and output is 30-
35mL/kg/day (about 2.4L/day)

15. •Kidneys plays a pivotal role in
regularization of fluid – electrolyte balance.
•Oral intake & urine output are imp.
measurable parameters.
•Fluid electrolyte output in normal day to
day life is in form of:-
a. Sensible- Urine output, Vomiting,
Diarrhoea, Excessive sweating
(100 ml / degree farenheit rise in temp)
b. Insensible- Lungs, Skin, Stools.

18. mEq = number of moles of a given ion in a solution/1000
Number of moles of solute that contribute to the osmotic pressure of a solution. A milliosmole (mOsm) is 1/1,000 of an osmole

19. Water requirements increase with:
Fever Sweating
Burns Tachypnea(abnormally rapid breathing )
Surgical drains Polyuria
Gastrointestinal losses through Vomiting or diarrhea
Restriction of oral intake

20. Fluid Replenishment

21. It is an effective, and efficient method of
supplying fluid directly into intravenous fluid
compartment producing rapid effect ,with
availability of injecting large volume
of fluid more than any other method of
administration.

22. Indications
 Coma, anaesthesia, Severe vomiting and diarrhoea,
 Dehydration and shock
 Hypoglycemia
 Vehicle for – antibiotics, chemotherapy agents
 TPN
 Critical problems – anaphylaxis, status asthmaticus or
epilepticus, cardiac arrest , forced diuresis in drug
overdose, poisoning

23. CRYSTALLOIDS COLLOIDS BLOOD & BLOOD
PRODUCTS

25. Water + Electrolytes
Crystalloids are aqueous solutions of mineral salts or other water-soluble molecules.
Expands intravascular volume to a lesser degree than Colloids.
Replenishes interstitial compartment.
Leaves intravascular space faster (t1/2 = 20-30 mins)
It increases GFR.
CRYSTALLOIDS

26. NORMAL SALINE
RINGER LACTATE
5% DEXTROSE (D5 / D5W)
10%, 25%, 50% DEXTROSE
D5 WITH HALF STRENGTH SALINE
CRYSTALLOIDS

27. DEXTROSE NORMAL SALINE (DNS)
ISOLYTE- G/E/M/P
DOUBLE STRENGTH HYPERTONIC SALINE
INVERTED SUGAR SOLUTION
(50% Fructose + 50% Dextrose)
CRYSTALLOIDS

31. Solutions that contain large molecules
that don't pass the cell membranes.
When infused, they remain in the
intravascular compartment and
expand the intravascular volume
COLLOIDS

32. 3. ALBUMIN (Human Serum Albumin) available in strengths of 5%, 25%
4. HETASTARCH (Hydroxy-ethyl starch) = 6% solution in isotonic saline (4,50,000 mol wt)
1. DEXTRAN Glucose polymer in sucrose medium
2. MANNITOL
COLLOIDS
5. GELATIN POLYMERS = 3.5% solution of polymer gelatin (containing of 35,000
mol wt) Also has Na, Cl, Ca, K
6. PENTASTARCH = low molecular wt derivative of Hetastarch (10% starch)

33. c. Blood and blood products
1.WHOLE BLOOD.
2.PACKED RED CELLS.
3.LEUCOCYTE DEPLETED BLOOD.
4.FRESH FROZEN PLASMA.
5.PLATELETS.
6.FREEZE DRIED FACTORS.

34. FLUID OVERLOAD (HYPERVOLEMIA)
Signs and Symptoms
1- Edema (swelling) - particularly feet, and ankles
2- Difficulty breathing while lying down
3- High blood pressure
4- Irritated cough
5- Jugular vein distension
6- Shortness of breath (dyspnea)
7- Strong, rapid pulse

35.  Mole : 1 mole is atomic wt or mol wt of that substance in gms
 Equivalent : atomic wt (mole) * valence
 Osmolality : number of moles of a chemical compound that contributes to the
solution's osmotic pressure and is expressed as mOsm/kg of water
 Osmolarity : number of osmoles of solute particles per unit volume of solution
(mosm/L)
 Osmotic pressure : pressure exerted by osmotically active particles in the fluid.
depends on number of particles / unit vol

36. KAMAL CHANDRA UPRETI
Product Management
kammph@gmail.com