Practical Applications of Intravenous Fluids in Surgical Patients Shaila Shodhan Kamat
INDEX
Page numbers followed by f refer to figure.
A
Abdominal distension 202
Abdominal tenderness 207
Abscess drainage 201
Acetate 63, 124
Acid-base
abnormalities 213
composition 69
disturbances 204
Acute renal failure, precipitation of 82
Adrenal insufficiency 239
Adrenaline 283, 284
Adverse drug reaction 111
Albumin 68, 7173, 76, 97, 127, 183, 239, 275
amount of 78
composition of 72
concurrently, bottle of 76
fluid evaluation 238
in blood 73
in critical illnesses 74
in health, functions of 73
influences coagulation 73
infusion 110
loss of 71
replacement, value of 74
solution 71, 76
stabilises 72
synthesis 71
types of 71
Aldosterone 23, 177
in water balance, role of 23, 25f
mechanism of action of 24, 24f
secretion 24, 25
Alkalaemia, severe 205
Alkalosis 211
Alveolar oedema 270
Amino acids 275
Amiodarone 284
Amphetamines 194
Anaesthesia 145
administering 198
in pre-eclamptic patients 253
regional 145
type of 156
Analgesia 253
Anaphylactic reaction 81, 111
Anaphylactoid
reactions 90, 111, 120
shock 98
Angiotensin 19
in water balance, role of 22, 23
role of 22f
Angiotensinogen 22
Anticipated operative time 156
Antidiuretic hormone 10, 11, 162, 167, 177
concentrations 14f
formation of 11f
in pregnant patients, role of 15
in trauma, role of 16
in water balance, role of 10
on kidney, effects of 16, 16f
on vascular system, effects of 17
physiological effects of 16
release of 15
secretion of 14, 133, 163
syndrome of inappropriate 143
synthesis of 11f
Antipyretic therapy 245
Anuria 151, 171
Arrhythmias 195
Arterial baroreceptors, high pressure 7, 8, 9f
Arterial blood 188
gas analysis 210
Arterial pressure 209
mean 239
Atrial natriuretic peptide 27, 150, 254
in water balance, role of 27, 28f
production of 232
Atropine fever 199, 200f
Autonomic nervous system 9
B
Bacteria and toxins, source of 196
Bainbridge reflex 8f
Baroreceptor 7
in regulation of water balance, role of 7
reflex 9, 9f
Betaine 227
Bicarbonate 204
Blood 111, 183, 209
and blood substitutes 275
component therapy 175
cross-matching, interference with 82
in suction bottles 212
rheology 242
substitutes 137, 184
sugar level, random 209
transfusion 58, 275
urea nitrogen 195
Blood glucose
level 197
measurement 163
Blood loss 150, 153, 175, 206
allowable 169, 175
compensate for 181
estimated 169
replace 222
replacement 152
Blood pressure 187, 246, 251, 282
non-invasive 260
normal 209
variation 280
Blood volume 158, 175
estimated 175
increased 7
Blood-brain barrier 217, 220, 242
across 213
in head injury, changes in 220
intact 243
Bloodstream 22
Body fluid
compartment, solute composition of 45f
composition of 1
distribution of 38, 44, 44f, 157
Body spaces, resuscitation of 143
Body temperature 191
variation in 190
Body water
compartment 48f
sources of 4
Body weight loss 209
Bowel exposure 174
Bowel obstruction 154
Bowel preparation 145
quality of 156
Bowel wall oedema 150
Bradycardia 120
Brain
capillary, structure of 217, 217f
natriuretic peptide 27
in water balance, B-type 27
in water balance, role of 28f
oedema 233
regulation 235
swelling 213
water 221
content 213
Brainstem herniation 239
Bronchospasm 120
Bucket analogy, hole in 155
Burn 78, 143
therapy 75
C
Calcium 73, 275
Caloric expenditure 161
Capillary filtration coefficient 215
Capillary hydrostatic pressure 234
Capillary microcirculation 214f, 269f
Capillary refill pressure 279
Capillary tissue fluid dynamics 140
Caprylic acid 72
Carbohydrate 144
Carbonic anhydrase inhibitor 205
Cardiac arrest 81, 196
Cardiac function 143
Cardiac output 183
Cardiac surgery 122
patients 121
Cardiogenic shock, patient with 187
Cardiopulmonary and renal function 156
Cardiopulmonary bypass 75
Cardiopulmonary system, effects on 249
Cardiovascular function 153
Cardiovascular instability 171
Cardiovascular stabilisation 237
Cardiovascular stable 201
Cardiovascular system 161
effects on 110
Catabolism, patients with increased 74
Cell volume, packed 209
Central nervous system 194
effects on 250
Central pontine myelinolysis 226
Central venous
catheter 281
pressure 188, 233, 237, 254, 268, 279
applications of 273
Cerebral blood flow 230, 235, 238
Cerebral dehydration 225
Cerebral irritability, increased 196
Cerebral ischaemia 239
Cerebral oedema 57, 223, 225, 234, 241, 251
formation of 219
Cerebral pathology 213
Cerebral perfusion pressure 237
Cerebral salt wasting 240
Cerebral vasospasm, effects of 230
Cerebrospinal fluid 226
Chest
radiograph 279
tightness of 81
Chloride 63, 124
Circulatory disturbance 90
Circulatory dysfunction 276
Clear-fluid losses 126
Clostridium welchii 195
Cocaine 194
Cold extremities 151
Colloid 66, 128, 135, 181, 183, 239
accepted statements of 130
advantages of 64
and crystalloid in body compartments, distribution of 54f
artificial 176
characteristics of 126
constitute 218
disadvantages of 64
electrolyte content 69
fluid 155, 274
general characteristics of 66
in brain, effects of 218
in fluid resuscitation 98
in perioperative period, current consensus on 128
indications of 70
intravenous fluid 97, 127
molecular
size 67, 67f
weight 66
natural 77
pharmacology of 66
plasma
half-life 69
substitute 69, 137
substitute, functions of 70
substitute, types of 69
volume expansion 67
synthetic 113, 129
theories favouring 135
use of 259
volume replacement by 222
Colloid molecules
enter 135
removal of 130
Colloid osmotic pressure 41, 68, 68f, 72, 216
avoid decrease in 259
reduction of 218
Colloid solutions 66, 112, 128, 129, 141, 183, 241
contain colloid 55
Colloidal active molecules 219
Colloidal osmotic pressure 73
Colon 203
Coma 151, 171
Compounds, transport of 73
Congestive cardiac failure 119
Corticosteroids 244
use of 244
Critically ill
patients 275
surgical patient 187
Crush injury 184
Crystalline solids in water, solutions of 53
Crystalloid 53, 96, 98, 126, 130, 181, 277
accepted statements of 130
administration 131
decreases osmotic pressure 241
advantages of 64, 98
characteristic of 53
controversy 274
over 135
disadvantages of 64
favouring therapy 186
fluids 135, 155
in brain, effects of 218
in perioperative period, current consensus on 128
intravenous fluids 65
mechanism of action of 55
pharmacology of 53
plasma substitutes 137
solutions 75, 129, 141, 144, 183, 241
types of 55
use of 259
volume replacement by 222
Cyclooxygenase
catalyses 198
enzyme 199
blocking action of 199
D
Deficit patients, chronic 173
Dehydration 207, 225
children
with moderate 173
with severe 173
clinical signs of 208, 209
degree of 208
estimation of degree of 170, 209
mild 170
moderate 171
severe 172, 209
severity of 171
sign of 177
type of 169
Desmopressin acetate 231
Dexamethasone treatment 224
Dexmedetomidine 284
Dextran 68, 79, 183, 276
general properties 79
interferes 82
low doses of 82
solution of 88
types of 79
Dextran 40 84, 87, 127
clinical uses 85
excretion 84
metabolism of 84, 86
pharmacological basis 84
Dextran 70 85, 86, 127
dose of 87
metabolism of 86
pharmacological basis 85
Dextran administration
complications with 81
disadvantages with 81
Dextran-induced anaphylactoid reactions, severe 81
Dextrose 55, 61, 63, 65, 138, 196, 197
administration, lower 134
advantages 58
and water for bolstering 201
avoid 164
containing solutions 141, 148
avoid 242
contraindications 57
disadvantages 58
indications 57
management during surgery 164
pharmacological basis 56
precautions 59
properties 56
safe rate of administration 56
solutions, administering 163
Dextrose saline 61, 98
indications 61
pharmacological basis 61
precautions 61
properties 61
Diabetes
insipidus 230
mellitus 155
uncontrolled 58
Diarrhoea 196
chronic 153
Dihydroergotamine 235
Dilated pupil, unilateral 243
Dilutional hyponatraemia 134
Diminished sensorium 151
Diphtheria 195
Dipotassium hydrogen phosphate 63
Diuretic therapy and hypotension, avoid 258
Dobutamine 283, 284
Dopamine 283, 284
actions of 266, 267f
in water balance, role of 29, 29f
Dopaminergic renal vasodilatation 29
Drug
dilutions for infusions 283
interactions 79
protocol, infusion of 284
Drying agent, avoid 199
Dysarthria 226
E
Eclampsia 247, 248
Electrocardiogram 210
Electrolyte 213
abnormalities 231
after estimation, replace 201
contents 65, 97, 127
disturbances 181
correction of 210
solution, balanced 125
Elevated metabolic activity 194
Emesis 207
End-expiratory pressure, positive 189, 266
Endogenous pyrogen 191
Endothelial cell layer 140
Endothelial glycocalyx layer 140
Endothelial leucocyte adhesion molecule-1 122
Endothelial surface layer 140
Endotoxaemia 112
Epidural analgesia decreases 256
Esomeprazole 284
Examiner's thumb 171
Exhausted adrenal cortex 196
Extensive cellulites 201
Extensor posturing 243
Extracellular compartment 40
Extracellular electrolytes, concentrations of 23
Extracellular fluid 45, 46, 52, 139, 157, 158, 180, 263
deficits 150
signs of 151
non-functional 159
replace 149, 150
treatment of 151
volume, decreased 204
Extracellular space 47f, 53
resuscitations of 143, 144
Extracellular tonicity 40, 228
Extracellular water 44, 158
constitutes 158
Extracorporeal circulation 92
F
Fasting guidelines 144
Fat 157
Febrile
diseases 191
reaction 60
Fentanyl 284
Fever 190, 194, 196
caused by brain lesions 193
clinical significance of 194
facts about 190
postoperative 194
reaction 192
two-thirds of 194
Filling space, priority of 146
Filtration fraction, decrease 22
Fluid 245
and electrolyte loss 196
and volume management, current controversies of 131
boluses 71
calculation of 283
drop rate calculation of 283
during aneurysmal surgery 229
for volume replacement, types of 137, 182
gelatins, modified 70
in infant and children 165
in intestinal obstruction 202
in neurointensive care units 231
in postoperative care units 231
in solid food 4
infusion of 212
ingested 4
intraoperative 180
load 132f
mechanism of action of 140f, 141
movement, basics of 215
overload, higher chances of 165
perioperative management of 221
preferred, types of 178
replacement 149, 274
required, smaller total volume of 165
requirement of 177
resuscitative 274
retention 154
selection of 201
shear stress 131
shifts, internal 154
types of 98, 172, 176, 241
with diabetes insipidus 230
within bowel lumen, sequestration of 203
Fluid administration 239
goals of 182
intraoperative 149
perioperative 168
route and rate of 187
Fluid balance 146, 261
influence of positive pressure ventilation on 266
Fluid calculation 172
for elective stable cases 173
Fluid deficit
assessment of 162
correction of 162
non-iatrogenic sources of 156
on physical examination, signs of 156
restoration, total 173
Fluid intake
remaining 272
typical 272
Fluid loss 178
intraoperative 174, 176
preoperative 207
typical obligatory 271
Fluid management
basic concepts in 237
decision pathway, perioperative 156
during surgery 164
goals of 210
in neurosurgery 221
in neurosurgical patients 213, 229
in postoperative period 177
in pregnant patients 256
with pre-eclampsia 259
in severe pre-eclampsia 258f
in surgery 153
in ventilated patient 263, 271
intermediate surgery 154
intraoperative 229
major surgery 154
minor surgery 153
of neurosurgical patients, intraoperative 222
of paediatric surgical patients 157
perioperative 166, 180
issues affecting 144
Fluid replacement
adequacy of 212
amount of 131
assessment of 212
principles of 145
surgical 152
Fluid requirement
assessment of daily 147
calculating 161
infants and older children maintenance 163
intraoperative 177
Fluid restriction
avoid 221
severe 221
Fluid resuscitation 236
adequate 222
standard or liberal 131
Fluid therapy
goals of intraoperative 174
in eclampsia 246
in fever 190
in infants and children 157
perioperative 157
in pre-eclampsia 246, 253
in trauma resuscitation 181
in traumatic brain injury 234
management of perioperative 166
monitoring 179, 278
perioperative 147
Fresh frozen plasma 67, 175
Furosemide 244
G
Gastric drainage 207
Gastric losses, chronic 153
Gastrointestinal fluid
composition of 203
loss of 152
volume of 203
Gastrointestinal loss 177
Gastrointestinal pathology 146
Gastrointestinal surgery 142
Gastrointestinal system 146
Gastrointestinal tract 205
Gelatin 69, 96, 277
administration, indications of 90
solutions 86
advantages of 89
clinical pharmacology 88
disadvantages 90
excretion 89
metabolism 89
pharmacokinetics 88
properties 88
undesirable side effects 92
type of 88, 96
Gelifundol 88
Gelofusine 88, 95, 96, 97
comparative effects of 96
indication 96
properties 95
unique benefits of 95
Glomerular filtration
decreased 21
rate 33, 159, 252, 263
Glucocorticoids 23
Glutamine 227
Glycerol 220
Goal directed therapy 181
Gut 195
H
H+ ion, loss of 205
Haemaccel 93, 97
contraindication 95
excretion 93
metabolism 93
mode of administration 93
pharmacological basis 93
properties 93
side effects 94
Haematocrit
decrease of 111
risen 210
Haematological disturbances 247
in pre-eclampsia 251
Haemodilution therapy 117
Haemodynamic stabilisation 98
Haemodynamic support 238
Haemodynamically unstable, treatment of 181
Haemoglobin 209
concentration 235
Haemorrhage 183
Haemorrhagic shock 78, 183, 226
Haes-Steril, effects of 114, 115
Hartmann's solution 134, 173
Head injury 122
Heart
failure 266
rate 187, 188, 209, 279
Heat stroke 194
HELLP syndrome 248, 252
Heparin 284
Hepatic artery bringing blood 196
Hepatic reserve, narrowed 196
Herring body 12
Hetastarch 68, 113, 120, 172, 239
Homeostatic responses, long-term 265, 266f
Hormone
in water balance, role of 2, 10
salt and water retaining 26
secretions 7
Human albumin 71
general properties 71
shelf-life and storage 71
Hydralazine injection 251
Hydrated, epidural analgesia 256
Hydrochloric acid, loss of 205
Hydrostatic forces 215, 218
Hydrostatic pressure 235
in capillary 270
Hydroxyethyl starch 70, 88, 99, 101, 106, 117, 172, 183, 276
advantages of 113
adverse reactions 120
balanced 125
clinical uses of 112, 119
concentration 99
contraindications 119
disadvantages 106
doses of 120
effects of 110
evaluation of 113
first-generation 113
general pharmacological properties of 99, 105
generations 127
indications 119
metabolism of 106
molecular weight 100
nomenclature of 104, 105f
on coagulation, effect of 109f
pharmacology of 99
plateau effect of 118f
saline 125
second-generation 114
solutions 110
special precautions 112
third-generation 117
type of 100, 120
warning and precautions 119
Hyperbilirubinaemia 254
mild to moderate 111
Hyperchloraemic acidosis 124
Hyperglycaemia 148, 164, 176, 224
augments 224
avoid 224
severe 58, 148
Hyperkalaemia 176
Hypernatraemia 58, 232, 278
Hypernatraemic extracellular fluid 227
Hyperoncotic renal injury 276
Hyperoncotic solution 115
Hyperosmolar fluid
newer 232
use of 225
Hyperosmolar therapy 242
Hyperosmolarity, acute 220
Hypertension 60, 248, 250
Hyperthermia, malignant 194
Hypertonic crystalloid solution 241, 277
Hypertonic saline 183, 220, 225, 226, 228, 242, 243
disadvantages of 226
dose of 228
therapy 226
Hypertonic solution 55
osmolality of 225
Hypertonicity 19
Hyperuricaemia 252
Hypervolaemia 229
Hypoalbuminaemia, patients with 74
Hypocalcaemia 176
Hypochloraemia 61, 205
Hypoglycaemia 197, 224
Hypokalaemia 204, 211, 232
aggravates 204
Hyponatraemia 37, 58, 134, 135, 167, 227, 231, 239, 240, 278
causes of 240
chronic 226
degrees of 219
severe 226
Hypo-oncotic solution 115
Hypoperfusion, severe 178
Hypotension 19, 81, 151, 171, 177, 222, 238, 250, 258
effects of 222
in pre-eclamptic parturients 250
severe 81
systemic 238
Hypothalamic neurosecretory neurones 10
Hypothalamic temperature controller 192, 193f
Hypotonic fluids 208
Hypotonic solutions 55
Hypovolaemia 13, 14, 19, 61, 91, 121, 142, 177, 185, 186, 188, 204, 213, 237
correction of 210
in antidiuretic hormone release, role of 14, 15f
preoperative 146
treatment of 245
Hypovolaemic patients 128
Hypovolaemic shock 57, 59
emergency treatment of 75
Hypoxaemia 142, 213, 249
Hypoxia 50, 274
avoid 199
Hypoxic ischaemic 251
I
Idiosyncratic drug reactions 194
Ileum 203
Immune system disorders 111
Impaired renal function 60
Infant, preterm 162
Infant's cardiopulmonary status 170
Infection 191
Inflammation 191
Influenza-like symptoms, mild 120
Infusion of albumin, indications for 74
Inositol 227
Inotropic drugs 181
Insensible loss 169
greater 165
Insensible water loss
abnormal 5
normal 4
Insulin 284
Intensive insulin therapy 232
Interleukin-I, role of 191, 192f
Interstitial compliance 218
Interstitial fluid 47, 51, 129, 168
acts 204
volume 158
loss of 208
Interstitial oedema 130, 150, 277
Interstitial pressure falls 216
Interstitial space
causes of over expansion of 50
constriction of 265
disadvantages of over expansion of 50
negative pressure in 49
Interstitium 219
Intestinal obstruction 207, 212
anaesthesiologist with 202
surgery 202
Intracellular dehydration 144
Intracellular fluid 45, 52, 157, 159
Intracellular gaps 217
Intracellular space 53
disadvantages of over expansion of 50
Intracellular tonicity 228
Intracranial hypertension 228, 237
Intracranial injury 234
Intracranial mass lesions 213
Intracranial pressure 220, 221, 223, 225, 226, 228, 234, 237
increase 236
lower 221
Intravascular fluid 46, 168
Intravascular persistence 98
Intravascular plasma volume 158
Intravascular pressure 218
Intravascular volume
deficiency 182
loss of 204
replacement 223
Intravenous fluid 133
composition of 166
replacement 254
start 197
Invoke delirium 199
Ionic solution 53, 55, 141
uses of 141
Ischaemic stroke, acute 58
Isolyte P 63, 65
contraindications 64
indications 64
pharmacological basis 63
precautions 64
Iso-oncotic solution 115
Isoprenaline 283, 284
Isotonic colloid solution 239
Isotonic crystalloid 239
amounts of 216
Isotonic electrolyte solution 124
Isotonic intravenous solutions 259
Isotonic saline 59
in body compartments 54f
Isotonic solutions 55
Isovolaemic haemodilution, acute 91, 116
Itching 111, 120
J
Jejunum 203
Juxtaglomerular apparatus 20f
nephron with 20f
Juxtaglomerular cells 19
K
Kidney 1, 20, 134, 195
in sodium reabsorption, role of 32, 33f
in water balance, role of 2, 30
supply blood flow to 160f
Kinins in water balance, role of 29
L
Labour 256
Lactate production, metabolic aspects of 236
Lactate-pyruvate ratio 236
Laparoscopic cholecystectomy patients 144
Laparotomy 5
Lasix (furosemide) 284
Leukocyte pyrogen 191
Levosimendan 284
Liberal fluid resuscitation 131
Liver 195
cirrhosis of 60
disease 73
effects on 251
enzymes, raised 248
failure 154
acute 75
surgery 142
transplantation, after 79
Lomodex 79
Loop of Henle
ascending 32
descending 32
Low glomerular filtration rate 159
Low osmolality outside cell 227f
Low plasma sodium, chronic 228
Low pressure
atrial baroreceptors 7
atrial stretch receptors 8f
stretch receptors 7
stimulation of 7
Lung 195
Lymphatic system disorders 111
M
Macrodex 79, 127
Macula densa 20
region 20
Magnesium 63, 73, 124, 152
chloride 63
Maintenance fluid 148, 162, 271
requirement 163
Mannitol 220, 225, 243
repeated administration of 244
use of 229
Maternal dehydration 16
Mechanical ventilation 175, 263
Medication, severe 178
Meningococcus 195
Mental status 188
Metabolic acidosis 155, 206
Metabolic alkalosis 205
aggravation of 205
correction of 211
Metabolic water 4
Metabolically generated water 272
Metabolism 56, 73, 86
and excretion 81, 114
Midazolam 284
Milrinone 284
Mineralocorticoids 23
Minimally invasive methods 279
Mitochondria 236
Molar substitution 101, 101f, 102f
Monodisperse 67
Motility, decreased 142
Mucous membrane 209
Multiple traumas complicate 234
Muscarinic receptor, acetylcholine for 200f
Myocardial depressant drugs, avoid direct 200
Myocardial efficiency, decreased 195
Myocardial irritability 195
N
N-acetyl-DL-tryptophan 72
Nasogastric
aspiration 211
suction 205
tube 210
Nausea 81
Neonatal
cardiac output 161
hypoglycaemia 254
intensive care unit 167
maintenance fluid requirement 162
myocardium 161
Neurohypophysis 12
Neuroleptic malignant syndrome 194
Neurosurgery 143
Neurosurgical patients, management of 213
Neurosurgical procedures 57
Newer developments 232
Nitroglycerine 284
Non-cardiac pulmonary oedema 120
Non-haemorrhagic hypovolaemia 186
Non-ionic solution 53, 55, 141
uses of 141
Non-ketotic hyperglycaemia 17
Non-osmotic stimulus 15
Non-protein nitrogen 195
Noradrenaline 283, 284
Normal saline 59, 98, 222
advantages 60
contraindications 60
disadvantages 60
indications 59
pharmacological basis 59
precautions 60
properties 59
Normovolaemia 229
Normovolaemic haemodilution, acute 91, 116
O
Oedema 249
body for prevention of formation of 51
formation 218
producing 216
rebound 225
Oligaemic shock 91
Oliguria 151, 177
in labour for vaginal delivery 256
postoperative 177
Oncotic pressure 216
gradient 130
in interstitium 270
Operation, type of 156
Optimal fluid
management 222
resuscitation 133
Oral carbohydrates 144
Oral feed, start 179
Orchidopexy 166
Organ dysfunction, postoperative 154
Osmolality 38, 40, 68
in antidiuretic hormone release, role of 13, 13f
outside cell, high 227f
outside cell, normal 227f
role of 13
sensors 35
Osmolar therapy 225
Osmolarity 38, 39, 124
Osmoles 38
Osmolytes 227
fall 227
Osmoreceptors
in water balance, role of 5, 6f
of hypothalamus 12, 12f
Osmosis 41, 42, 42f, 138
fundamental physiology of 42
Osmo-sodium receptors in water balance, role of 5
Osmotic activity, basic concepts of 38
Osmotic diuresis 146
Osmotic forces, equalisation of 43
Osmotic molecules 55
Osmotic pressure 41, 268
effective 41
Osmotic reflection coefficient 215
Otoneurological disorders, precautions in patients with 117
Overhydration 90
risk of 98
Oxygen 256
delivery 253
transport in high-risk 187
Oxypolygelatins 70, 88
Oxytocin drip 254
P
Paediatric intensive care unit 136, 163
Pancreas 203
Pantoprazole 284
Paradoxical aciduria 205
management of 205
Parsimonious fluid therapy 272
Pentastarch 126
Perfluorocarbons 184
Peripheral capillary, structure of 215, 216f
Peripheral oedema 50, 60
formation of 219
Peripheral perfusion 208
Peripheral pulse, poor 151
Peripheral tissue 221
Permeability pulmonary oedema 271
pH 124, 172
Pharmacodynamics 117
Pharmacokinetics 118
Phenylephrine 284
Phosphate 63, 152
Pituitary gland 230
posterior 10, 11f
Pituitary hormones, posterior 10
Placental changes 253
Plasma 46, 129, 168, 206, 239
bilirubin, effects on 111
colloid osmotic pressure 79, 98
derivative, naturally occurring 69
exchange 91
factors 206
normal 72
osmotic pressure, normal 268
substitute 137
tonicity 39
Plasma osmolality 14f, 39
factors influencing 239
in water balance, role of 264
Plasma protein 88
decrease of 111
fraction 67, 73
Plasma volume 155, 158, 203
comparative 98
decreased 195
expansion 77
homeostatic responses to maintain 264
loss of 208
substitutes 91
Plasmagel 88
Plasmion 88
Platelet
contain 175
transfusion 175
Polydisperse 67
Polygeline 88, 96
comparative effects of 96
Positive end-expiratory pressure, effects of 267f
Positive pressure ventilation, effects of 267f
Postrenal oliguria 178
Potassium 63, 72, 124, 152
chloride 63, 178
content 96
Practical fluid balance 138
basic principles 138
Pre-anaesthetics consideration 207
Pre-eclampsia 246, 248
classification 247
incidence of 246
severe 247
Pre-eclamptic patients 256
after parturition, care of 262
mild 257
severe 257
Pregnancy induced hypertension 246
classification of 247
Prehydration 257
basic concepts of 254
with hypotonic fluid, avoid 167
Preload-central venous pressure, measure of 188
Prerenal oliguria 178
Pressure stretch receptors 7
Pressure ventilation, positive 266, 268
Preterm labour, women at risk for 16
Pro-inflammatory cytokines 122
Prophylactic crystalloid solution 147
Prostaglandins 22
in water balance, role of 29, 30f
Protein
membrane basic 238
molecules 47
rich fluids, sequestration of 75
Proteinuria 92, 246, 248
Pruritus 111, 120
Pulmonary artery
catheter 281
occlusion pressure 273, 279
wedge pressure 230
Pulmonary capillary wedge pressure 255
Pulmonary function 143
Pulmonary oedema 50, 60, 256, 260, 273
acute 273
management of acute 261
postobstructive 271
signs of impending 257
Pyrexia 207
Pyrogens 191
in causing fever, mechanism of action of 191
R
Randomized controlled trials 145
Red blood cells, packed 176
Refractory vomiting 205
Regional anaesthesia, prehydration before 255
Regional analgesia, precautions before initiation of 255
Rehydration 172
Rehydration therapy 172
before surgery, goals of 172
monitoring 174
Renal artery hypotension 21
Renal blood flow, low 159
Renal causes 177
Renal effects 84
Renal failure 83, 155, 165, 225
acute 155
avoid 83
incidence of 146
Renal filtration 31f
Renal function 110, 143, 153, 170, 261
effects on 110
test, abnormal 83
Renal insufficiency 123
Renal oliguria 178
Renal physiology 159
Renal sympathetic nerves 21
Renal system, effects on 252
Renal units, basic 160f
Renal water handling 31
Renin
factors influencing release of 21, 21f
in water balance, role of 19, 22
primary function 22
Renin-angiotensin-aldosterone system 26f, 265f
Respiratory acid-base disorder 206
Respiratory arrest 81
Respiratory muscles 195
Respiratory rate, increased 195
Respiratory system, effects on 252
Respiratory variation in systolic 279
Restricted fluid resuscitation 132
Resuscitation 210
fluids 182, 185, 274
in trauma patients 184
Reticuloendothelial system 106
Rhabdomyolysis, severe 178
Rheomacrodex 127
Ringer's lactate 61, 62, 98, 134, 141, 169, 173, 180, 223, 229, 233, 239
contraindications 63
indications 62
pharmacological basis 62
precautions 63
solution 241
Ringer's solution 61, 245
S
Saline 65, 180, 238
solution 125
Saliva 203
Salt solution
balanced 129, 149, 150
infuse balanced 211
Semisynthetic colloid 69
Sensible water losses 4
Sensorium changes 171
Septic shock 74
Serotonin syndrome 194
Serum
amylase, increase of 111
biomarker levels 238
electrolytes 179
oncotic level 78
osmolality 239
tonicity 226
Sex hormones 23
Shock 81, 171
bacteraemic 196
original 181
Short-term homeostatic responses 264, 265f
Sick newborn 176
Skin 171, 195
colour 209
disorder 111
turgor 209
decreased 171
Sodium 37, 46, 63, 72, 124, 218
accounts 6
acetate 63
and water
metabolism 37
retention 266
balance 213
chloride 117, 134
concentration 39
regulation of 3, 34f, 35, 35f
content 225
in antidiuretic hormone release, role of 36f
in controlling water balance, role of 264
in extracellular fluid 6
in hyponatraemia, correction of 228
nitroprusside 284
solutions
containing 141
without 141
Starch 97
Starling equation 213, 268, 269
Starling's forces 213, 269
Starling's hypothesis 39, 213, 214, 269
Steril 120
Stomach 203
Streptococcus 195
Subcutaneous tissue disorder 111
Succinylated gelatin 96
Surgery
and stress response 142
moderate 174
superficial 174
types of 142
System organ class 111
adverse drug reaction 111
Systemic abnormalities, existing 170
Systemic derangements 202
with intestinal obstruction 202
Systemic inflammation, effects on 122
Systolic blood pressure 279
T
Tachycardia 120, 151, 171, 209
Tachypnoea 171
Temperature 175
controller 192
Tetrastarch 117, 118f, 121, 126
Thirst mechanism
absence of 165
factors influencing 18, 18f
Thrombocytopenia 248, 251
Thromboembolic complications 143
Thromboprophylactic effect 80
Thyroxin 275
Tissue
oedema 98
oxygenation 121
Tonicity 40
clinical significance of 40
of solution 219
Tonsillectomy 166
Total body water 1, 51, 157, 158
childhood 43
compartmental distribution of 43
content 263
distribution of 1
elderly
females 43
males 43
newborn infant 43
regulation of 2, 3f
young adult
females 43
males 43
Toxaemia 206
of pregnancy 60
Toxic
bacteria 191
shock 195
Transcapillary refill 204
Transcellular fluid 48, 168
losses 150
Transcellular water 48
Transfusion, complications of 189
Traumatic brain injury 230, 232, 234, 236, 237, 242
patient 237
salt and water balance in 244
severe 237
Traumatic shock 187
Traumatised brain 239
U
Units of measurement 38
anion 38
cation 38
ions 38
Urea 220
cross-linked gelatin 88, 96, 127
solutions 69
Urinary calcium excretion 252
Urinary excretion of water 30f
Urinary loss, greater 165
Urine 210
concentrating ability 161
low output of 177
osmolality 240
output 209, 279
production 35
hormonal control of 33, 33f
specific gravity 172, 208
Urosurgery 122
Urticarial, generalised 81
V
Vaginal delivery, labour for 256
Vasopressor drugs 181
Ventricular arrhythmias 204
Vicious cycle 218
Volulyte 120, 124
Volume expansion
acute 256
degree of 77, 104
therapeutic options in 98
Volume loading, benefits of 212
Voluven 117, 120, 122
Vomiting 81, 203
W
Water 196
and electrolyte
causes of deprivation of 203
disturbances 202
balance 6, 35, 263, 268
arginine vasopressin in 10
in body, control of 5
normal 1
role of thirst in 17
content of food 272
control in body 52
diffusion of 42
for injections 72
free permeability of 42f
homeostasis 1, 1f, 36f
regulation of 34f, 35, 35f
intake of 24
consumption of 3
intoxication 58
movement, principles of 213
output 2, 4, 4f
Wheezing 81
Whole blood and plasma 137
Wound surfaces, exposed 150
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Chapter Notes

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