Understand principles of fluids, fluid compartments and composition
Identify role of kidneys in fluid management
Establishing Target Weight
Understand consequences of fluid overload
Assessing and implementing successful fluid overload management practices according to guidelines
The purpose of this presentation is to provide an overview of fluid and electrolyte maintenance related handicaps and physiological changes in early neonatal period and its management in brief.
Understand principles of fluids, fluid compartments and composition
Identify role of kidneys in fluid management
Establishing Target Weight
Understand consequences of fluid overload
Assessing and implementing successful fluid overload management practices according to guidelines
The purpose of this presentation is to provide an overview of fluid and electrolyte maintenance related handicaps and physiological changes in early neonatal period and its management in brief.
Iv fluid therapy (types, indications, doses calculation)kholeif
All what you need to know intravenous fluids, types, indications, contraindications, how to calculate fluid rate and drug dosages.
Embed code (http://www.slideshare.net/slideshow/embed_code/16138690)
Water and Electrolyte balance in surgical patientsDaniroxx
To help understand the need for Iv fluid therapy and electrolyte imbalances and their correction in surgical patients. It aims to keep the patient well hydrated with good urine output and avoid vital sign derangements and to avoid complications of wrongly advised fluids.
intravenous fluid and electrolytes are important topics in medical science. potassium is one of the vital electrolytes of the human body. this presentation has a discussion on several iv fluids and potassium balance and also how to manage the potassium imbalance.
Similar to Maintenance IV fluids in pediatrics (20)
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
6. Osmolarity vs. Tonicity
Osmolarity : concentration of solute in
a volume of fluid (eg. mOsmol/Liter)
Tonicity : As Osmolarity but measures
only solutes which can NOT pass the
semipermiable membrane
7. • Hyperosmolar solution is NOT necessarily a Hypertonic solution
• eg. Osmolarity of Glucose 5% in the Bag = ~250 mOsm/L (near plasma
osmolarity) ,but once infused in body is rapidly metabolized = considered
hypotonic solution
• Normal plasma Na level = 135 - 145 mEq/L
• Any fluid with sodium content near this concentration = Isotonic (eg.
NS or LR )
• fluids with lower Na content = Hypotonic (eg. Saline 0.18% - 30
mEq/L)
8. Effect of plasma fluid tonicity on body cells
Normal Plasma
Body cell
Hypertonicity
Smaller cell
Hypotonicity
Edematous cell
Brain cells
RBCs
9. Challenges in Hospitalized Children
• Normally :
Hyponatremia -> Inhibit thirst center -> Decrease water intake
• Hospitalized child :
No control of fluid intake (IV fluids) -> more hyponatremia
10. Role of ADH in producing hyponatremia
• Effect :
prevent water loss in urine -> retention -> decrease Na concentration
(dilution)
• Triggers :
• Osmotic : Hypernatremia
• Non-osmotic : GE (Vol. deplition) / Chest infection / CNS infection / Surgery
(Pre or Post) / Stress / Pain
11. Isotonic VS. Hypotonic maintenance fluids
• Many studies on pubmed (RCTs, Meta-analysis) compared effect of
Isotonic vs. hypotonic solutions and all suggested Isotonic to be of
choice due to less side effects (hyponatremia) compared with
hypotonic solutions.
12. Isotonic VS. Hypotonic maintenance fluids
• Nelson 20th Textbook :
• 0.2NS is no longer recommended as a standard maintenance fluid and its use
is restricted at many hospitals.
• D5 1/2NS + 20 mEq/L KCl is recommended in the child who is NPO and does
not have volume depletion or risk factors for nonosmotic ADH production.
• Children with volume depletion, baseline hyponatremia, or at risk for
nonosmotic ADH production (lung infections such as bronchiolitis or
pneumonia; central nervous system infection) should receive D5 NS + 20
mEq/L KCl.
13. Isotonic VS. Hypotonic maintenance fluids
• Nelson 20th Textbook :
• Electrolytes should be measured at least daily in all children receiving more
than 50% of maintenance fluids intravenously unless the child is receiving
prolonged intravenous fluids (TPN).
• Patients with persistent ADH production because of an underlying disease
process (syndrome of inappropriate ADH secretion, congestive heart failure,
nephrotic syndrome, liver disease) should receive less than maintenance
fluids.
14. Isotonic VS. Hypotonic maintenance fluids
• Nelson 20th Textbook :
• Fever increases 10-15% maintenance water needs for each 1°C above 38°C (if
persistent)
• Replace ongoing loss in Diarrhea
Solution: D5 1/2NS + 30 mEq/L sodium bicarbonate + 20 mEq/L KCl
• Replace ongoing loss in Vomiting
Solution: normal saline + 10 mEq/L KCl
15. From history :
Holliday and Segar calculations (1957)
• Caloric requirements = between BMR & Energy Expenditure after
normal activity
• 100 cal/kg per day (for patients weighing up to 10 kg)
• 1000 cal + 50 cal/kg per day per kg over 10 kg (10-20 kg)
• 1500 cal + 20 cal/kg per day per kg over 20 kg (>20 kg)
• After calculating Urine output + Insensible water loss
(Skin/Respiratory) >> for every 100 kcal = 100 mL water loss
(Urine loss 66.7 + Insensible 50 - Metabolic product 16.7 = 100)
• Estimation of electrolytes requirements was based on human milk
content of sodium, potassium & chloride
• Na = 3mEq/100 mL = 30mEq/L = 0.18% Saline (4:1)
16. Glucose
• D5 = 20% of caloric needs per day
• Prevent protein degradation & ketone production
• will loose weight (1% per day) = need TPN or Enteral feeding
17. Hypotonic fluids are preferred ?
• The purpose of maintenance fluids is not to restore volume deficit but
to replace urinary and insensible losses. Thus, giving an isotonic
solution to a hypovolemic ill patient to restore intravascular volume
will suppress ADH secretion. When ADH secretion is suppressed, a
hypotonic maintenance fluid will not cause hyponatremia.
• The answer : The tonicity of the maintenance fluid therapy is more important
than volume in the prevention of hyponatremia. As hypotonic maintenance
fluid therapy administered at a lower volume (one-half to two-thirds
maintenance) has a higher rate of hyponatremia compared with isotonic
maintenance fluid therapy.
18. Hypotonic fluids are preferred ?
• the increased sodium load may lead to volume overload and/or
hypernatremia; isotonic maintenance fluids contain approximately 5
times as much sodium as the ‘‘old maintenance."
• The answer : randomized studies have addressed these concerns & isotonic
maintenance fluid can be safely administered in standard maintenance
volume without causing hypernatremia.
19. Some basic calculations
10 grams glucose
+ 100 mL water
= glucose 10%
5 grams glucose
+ 50 mL water
= glucose 10%
5 grams glucose
+ 50 mL water
= glucose 10%
5 grams glucose
+ 100 mL water
= glucose 5%
20. Some basic calculations
0.9 gram Saline
+ 100 mL water
= Saline 0.9%
(Normal Saline)
0.45 gram Saline
+ 50 mL water
= Saline 0.9%
(Normal Saline)
0.45 gram Saline
+ 50 mL water
= Saline 0.9%
(Normal Saline)
0.45 gram Saline
+ 100 mL water
= Saline 0.45%
(Half Normal Saline)
21. D5 NS
= each 100 mL contains
5 grams glucose + 0.9 grams saline
D5 1/2NS
= each 100 mL contains
5 grams glucose + 0.45 grams saline
22. Indications for fluid restriction
• Cases with persistent ADH secretion
• ALI & ARDS
• CNS Infection (SIADH ?)
• CHF
• Liver disease
• Surgery
• Cases with decrease water loss
• Renal Failure (Oliguria)
• Mechanical ventilation
23. Final thoughts
1. Maintenance fluids are only temporary and you should start oral
feeding as soon as possible.
2. Only restrict fluids in previously mentioned cases
3. Apply the suggested new fluids concentration (D5 ½NS)
4. Increase maintenance fluids according to the condition (Fever,
Vomiting, Diarrhea)