5896dc56-8936-4614-a558-1c7d7ebd594c.pptx

1. Crystalloids
- Dr Priyank Preyas

2. Synopsis
• Introduction
• Basics
• Some Examples
• Advantages of Crystalloids
• Disadvatages of Crystalloids
• Colloids (In brief)
• References

3. Introduction
Defnition- Ion containing low molecular weight fluids that are able to
cross semi-permeable membrane.
Examples-
NS
DNS
Ringer Lactate (Most physiological fluid)
Half NS
3% NS
5% Dextrose

4. Basics
Total Body Water- 60% of body weight
. (A) Intracellular- 2/3 (40% of body
weight)
(B) Extracellular - 1/3 ( 20% of total body
weight)
Intravascular- ¼ (Target for fluid
therapy)
Extravascular- ¾
Plasma Osmolarity- 280-290 mOsmol/L

5. • A) 0.9% NS
• Na-154 mOsmol/L
• Cl-154mOsmol/L
• Iso-omolar
• Infusion of large volume may cause
hyperchloremic metabolic acidosis
B)Half NS
• Osmolarity is half of NS
• May cause Cerebral Edema in patients with (N)
sodium values

6. • C) 3% NS
• Hypertonic
• Na- 513 mOsmol/L
• Cl- 513mOsmol/L
• Used when there is severe symptomatic hyponatremia
( seizures or coma) or when there is severe
hypovolemia.
• However, it can cause phlebitis, necrosis of
veins, hemolysis.
• It has more molecular weight, so has to be avoided
in congestive heart failure or renal insufficiency
patients.
• Further it has to be given only by larger veins,

7. • D) 5% Dextrose- 252 mOsmol/L.
• Electrolyte free
• It can be used for nutrition and hypernatremic management.
management.
• Metabolizes to water and CO2
• E) DNS-
• 0.9% Saline+ 5% dextrose.
• Na-154 mOsmol/L and Cl- 154 mOsmol/L with 5g of glucose
glucose

8. • F Ringer Lactate- Osmolarity-272 mOsmol/L
• pH-6.5
• Contains Sodium lactate which is a bioenergy fuel under
fuel under ischemic conditions.
• Previously it was believed that RL should be used cautiously in
used cautiously in patients with hepatic failure as it was
failure as it was believed the lacate levels will rise in them .
will rise in them .
• It can be used along with blood transfusion but not in the same
not in the same line. Further it won’t cause microthrombi

9. • G) Plasma Lyte A-
• Ph of 7.4
• It has K, Mg, acetate and gluconate
• It however has a lower chloride content.

10. Advantages of Crystalloids
• Cheap
• Easily available
• Being low molecular weight they can be
administered to patients of Congestive Heart
Failure and Renal Failure
• There minimal chances of allergy or
anaphylactic reactions from these fluids.
• Lesser chances of causing thrombophlebitis and
necrosis of vein
• They may be administered through peripheral
veins

11. Disadvantages of Crystalloids
• More amount of fluids are required for blood
replacement
• They may cause electrolyte imbalance
• They may cause rigors and chills
• They can cause fluid overload
• Need to be used judiciously in patients of CKD

12. Colloids
• High molecular weight fluids
• They cannot cross semi permiable membrane so
they remain inside blood vessel only
• Examples
• - Albumin
• - Gelatin
• - Dextrans
• - HES

13. References
• Stoelting’s Pharmacology and Physiology in
Anesthetic Practice. South Asian Edition.
Pamella Flood, James P Rathmell, and Richard D
Urman.
• Morgan and Mikhail’s Clinical
Anaesthesiology.7th Edition. John F Butterworth,
David C Mackey and John D Wasnick