peakliner.blogg.se - Maintenance fluid calculator

Determine the approximate deficit and the cause by: The quantity of fluid replacement depends on your estimate of the fluid deficit.

Ongoing losses (prescribe fluids to replace future losses as they are likely to occur).

Pre-existing fluid deficit (replaced using STAT boluses).

Two components need to be considered when replacing fluid losses: FFP/platelets to stop the bleeding rather than just replace the lost red cells. If the patient continues to bleed, they may also need other products, e.g.

Blood loss: should be replaced with blood.

However, if these patients are hypotensive and need a fluid bolus, use Hartmann’s solution or 0.9% saline, because a larger volume will stay in the intravascular space. due to poor intake: should be replaced by normal maintenance-type fluids (e.g.

NB: if a patient needs a lot of sodium-rich fluid resuscitation, Hartmann’s solution is preferred to 0.9% saline because it contains less chloride (too much chloride causes a hyperchloraemic acidosis).due to diarrhoea and vomiting, NG aspirates, stomas, burns, pancreatitis, sepsis: this should be replaced with a fluid similar to extracellular fluid, which is similar to plasma (e.g. Extracellular fluid/volume depletion, e.g.1L Hartmann’s solution (over 10 hours) + 1L 5% dextrose with 40mmol K + (over 8 hours) + 500ml 5% dextrose with 20mmol K + (over 6 hours)įluid losses should be replaced with fluids which have a similar electrolyte content to the fluid that has been lost. The main types of fluid loss and what they should be replaced with are:.500ml saline 0.9% with 20mmol K + (over 6 hours) + 1L dextrose 5% with 20mmol K + (over 10 hours) + 1L dextrose 5% with 20mmol K +(over 8 hours).1L dextrose-saline with 20mmol K + (over 10 hours) + 1L dextrose-saline with 20mmol K + (over 10 hours) + 500ml dextrose-saline (over 4 hours).Thus for a 70kg patient, maintenance regimens need to provide approximately 2.5L fluid, 70-140mmol Na +, and 35-70mmol K +). The fluids you give should always reflect the patient’s weight. This is only acceptable for a very large patient because it provides about 0.5L more water and more sodium than is required for an average patient. This gives 3L H 20, 154mmol Na + and 60mmol K +. 1L dextrose 5% + 20mmol potassium chloride (over 8 hours).1L saline 0.9% + 20mmol potassium chloride (over 8 hours).Note, there are problems with the traditional fluid regimen of ‘1 salty + 2 sweet’:

By convention, bags are given over multiples of 2 hours. Calculate how much of all of these are needed and choose fluids which match these requirements closest. The type of fluid does not matter provided that, over 24 hours, it approximately matches the patient’s weight requirements of water, sodium and potassium. You will usually be giving fluids for either maintenance or replacement rather than both – but you need to be clear in your own head what you are doing! Maintenance fluids The type and quantity of maintenance fluid is based on the patient’s fluid and electrolyte requirements (dependent on their weight), and the type and quantity of replacement fluid is based on the type and quantity of fluid lost. When prescribing fluids, you need to be clear about what type of fluid you are prescribing, how much of it, and why. The different components of the above formula should be considered separately because each may need a different fluid prescribed.