Fluid_Therapy_Presentation_Fundamentals.pptx

Fundamentals of fluid therapy

1. Fluid Therapy: Principles & Clinical Applications Presented by: [Your Name] Date: [Your Date]

2. Introduction • Fluid therapy refers to the administration of fluids to maintain or restore body fluid balance. • Essential in perioperative care, critical care, and emergency medicine.

3. Body Fluid Compartments • Total Body Water (TBW) = ~60% of body weight • Distribution: - Intracellular Fluid (ICF) – 40% - Extracellular Fluid (ECF) – 20% - Interstitial – 15% - Intravascular (Plasma) – 5%

4. Indications for Fluid Therapy • Resuscitation: Hypovolemia, shock, sepsis • Maintenance: Unable to take oral fluids (e.g., NPO patients) • Replacement: Dehydration, electrolyte imbalances, blood loss • Special Cases: Burns, renal failure, DKA

5. Types of Fluids • Crystalloids: - Isotonic (0.9% NS, Ringer’s lactate) - Hypotonic (0.45% NS, D5W) - Hypertonic (3% NS, 7.5% NS) • Colloids: - Albumin, Hydroxyethyl starch (HES), Gelatins • Blood Products: - Packed RBCs, Fresh Frozen Plasma, Platelets

6. Choosing the Right Fluid • Crystalloids vs. Colloids: Pros and Cons • Patient Condition-Based Selection: - Trauma/Blood Loss → Blood Products - Dehydration → Crystalloids - Hypoalbuminemia → Albumin - Brain Injury → Hypertonic Saline

7. Fluid Resuscitation Strategies • Goal-Directed Therapy (GDT) • Early vs. Delayed Resuscitation • Assessment of Fluid Responsiveness: - Passive Leg Raise (PLR) Test - Central Venous Pressure (CVP) Monitoring - Stroke Volume Variation (SVV)

8. Complications of Fluid Therapy • Volume Overload: Pulmonary edema, CHF • Electrolyte Imbalance: Hypernatremia, Hyponatremia, Hyperkalemia • Acid-Base Disturbances: Hyperchloremic metabolic acidosis (with NS) • Colloid-Associated Risks: Coagulopathy, anaphylaxis

9. Special Considerations in Anesthesia • Perioperative Fluid Management • Enhanced Recovery After Surgery (ERAS) Protocols • Restrictive vs. Liberal Fluid Therapy

10. Conclusion • Fluid therapy is crucial in patient management. • Individualized approach based on clinical assessment. • Balance between under-resuscitation and fluid overload.

11. Strategies of Fluid Therapy • Goal-Directed Therapy (GDT): Based on hemodynamic monitoring (SVV, PPV, CO, lactate). • Restrictive vs. Liberal Fluid Therapy: - Restrictive: Used in surgical/ICU patients (ERAS protocols). - Liberal: Used in trauma, burns, and severe dehydration. • Early vs. Delayed Resuscitation: - Early: Sepsis, burns, hemorrhagic shock (30 mL/kg crystalloid). - Delayed: Trauma patients (permissive hypotension, SBP ~90 mmHg). • Fluid Challenge Approach: Small boluses (250-500 mL), reassess response. • Balanced vs. Unbalanced Fluids: - Balanced (Ringer’s Lactate, PlasmaLyte) preferred over 0.9% NaCl. • Special Considerations: Burns (Parkland formula), Sepsis, Trauma, CHF/Kidney Disease.

12. Advanced Hemodynamic Monitoring • Goals: Assess cardiac output (CO), tissue perfusion, and fluid responsiveness. • Key Parameters: - CO, SV, SVR, CVP, PAP, SvO₂, SVV, PPV. • Invasive Monitoring: - Pulmonary Artery Catheter (Swan-Ganz), Arterial Line, PiCCO System. • Non-Invasive Monitoring: - Esophageal Doppler, NICOM System, Pulse Contour Analysis. • Fluid Responsiveness Assessment: - Passive Leg Raise (PLR) Test, SVV/PPV (>13-15%). • Clinical Applications: - Sepsis, shock, cardiac surgery, ICU management.

13. Fundamentals of Fluid Therapy • Principles: Maintain homeostasis, individualized approach. • Body Fluid Compartments: - TBW = 60% of body weight (ICF 40%, ECF 20%). • Indications: - Resuscitation (shock, trauma), Maintenance (NPO), Replacement (fluid loss). • Types of Fluids: - Crystalloids: Isotonic (NS, RL), Hypotonic (0.45% NS), Hypertonic (3% NS). - Colloids: Albumin, Hydroxyethyl Starch (HES), Gelatins. - Blood Products: PRBCs, FFP, Platelets. • Strategies: Goal-directed therapy, restrictive vs. liberal approach. • Complications: Volume overload, electrolyte imbalance, acid-base disorders.