C:\documents and settings\administrator\桌面\11 fluid therapy

Download C:\documents and settings\administrator\桌面\11 fluid therapy

Post on 17-Jan-2015




5 download

Embed Size (px)




<ul><li> 1. Fluid Therapy The first affiliated hospitalSUN YAT-SEN university Prof.Wang Huishen </li></ul> <p> 2. Lastlesson EmphasisEtiology (in/ex/no) Pathogenesis (4+ex/b/v/no)Clinicalmanifestation Diagnosis Differential Diagnosis (p/d/n) Treatment Predisposing (4) 3. </p> <ul><li>Not difficult </li></ul> <ul><li>According to clinical manifestation, laboratory tests and character of stool.</li></ul> <p>Diagnosis+ + Infectious Or NoninfectiousDehydration Degree and quality Electrolyte disturbances And Disturbance ofacid-base balance 4. Severity clinical signs of dehydration Dehydrationmild moderate severe Water loss By weight SpiritSkin MocousAnterior fontaneland eye ball Tear Urine output Peripheralcirculation 50ml/kg 5% Slightly dispirited slightly agitated Slightly dry Slightly dry Slightly depressed Normal Slightly reduced normal 50 100ml/kg 5% 10% Dispirited Agitated Dry, pale Very drydepressed Reduced Little or NoLittle cool 100 120ml/kg 10% Extremely dispirited apathy, hypnody, coma Gray mottled Parcheddepressed greatly No No urine output Cool, weak pulse,shock 5. Dehydration Same proportionloss P IF C P IF C Electrolyte loss more Phypotonic, IF+Chypertonic Cell expansion Severe Easy to shock P: plasma,IF:interstitial fluid, C: cell Isotonic P IF C Water loss more P hypertonic IF+Chypotonic Cell hydration Mild Thirsty Acute diarrhea after vomiting greatly Hypotonic HypertonicNa+: 130 150mmol/L Na+: 150mmol/L 6. Electrolyte disturbance Diarrhea complicated </p> <ul><li>hyponatremia &amp; hypernatremia </li></ul> <ul><li>hypokalemia </li></ul> <ul><li>hypocalcemia</li></ul> <ul><li>hypomagnesemia </li></ul> <p> 7. </p> <ul><li>K +(potassium)</li></ul>