1 / 26

Fluid volume deficit, excess and water intoxication

Fluid volume deficit, excess and water intoxication. Fluid Volume Disturbances. Fluid Volume Deficit (Hypovolemia). Fluid Volume Deficit. Mild – 2% of body weight loss Moderate – 5% of body weight loss Severe – 8% or more of body weight loss. THREE TYPES OF deficit.

Download Presentation

Fluid volume deficit, excess and water intoxication

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Fluid volume deficit, excess and water intoxication

  2. Fluid Volume Disturbances • Fluid Volume Deficit (Hypovolemia)

  3. Fluid Volume Deficit • Mild – 2% of body weight loss • Moderate – 5% of body weight loss • Severe – 8% or more of body weight loss

  4. THREE TYPES OF deficit • Hyperosmolar fluid volume deficit- water loss is greater than the electrolyte loss • Isosmolar fluid volume deficit – equal proportion of fluid and electrolyte loss

  5. Fluid Volume Deficit • Pathophysiology – results from loss of body fluids and occurs more rapidly when coupled with decreased fluid intake

  6. Fluid Volume Deficit • Clinical manifestations • Acute weight loss • Decreased skin turgor

  7. Fluid Volume Deficit - Oliguria - Concentrated urine - Postural hypotension - Weak, rapid, heart rate - Flattened neck veins - Increased temperature - Decreased central venous pressure

  8. Severe vomiting Traumatic injuries Ileostomy Burns Use of diuretics ETIOLOGY AND RISK FACTORS

  9. LABORATORY FINDINGS • Increased osmolality(> 295 mOsm/ kg) • Increase BU (>25 mg / L ) • Elevated hematocrit (> 55%) • Increased specific gravity of urine ( > 1.030)

  10. MANAGEMENT Management of fluid in patient with fluid deficit should aim at Replacing deficit Correcting ongoing losses Maintenance

  11. Management of mild deficit • Mild fluid volume loss can be corrected with oral fluid replacement

  12. Management of moderate/severe volume deficit • IV fluids needed

  13. Fluid Volume Excess (Hypervolemia)

  14. Fluid Volume Excess • Pathophysiology – may be related to fluid overload or diminished function of the homeostatic mechinisms responsible for regulating fluid balance

  15. ETIOLOGY AND RISK FACTORS • Heart failure • Renal disorders • Cirrhosis of liver • Increased ingestion of high sodium foods • Excessive amount of IV fluids containing sodium • Electrolyte free IV fluids • SIADH,Sepsis • decreased colloid osmotic pressure • lymphatic and venous obstruction • Cushing’s syndrome & glucocorticoids

  16. Why does heart failure leads to oedema • Reduced renal perfusion--- activates renin angiotensin aldosterone mechanism---- results in fluid retention

  17. Why does renal failure cause oedema? • Why does liver failure cause oedema

  18. CLINICAL MANIFESTATION • Dyspnea & crackles in lungs • pleural effusion • Neck veins prominant • Bounding pulse &elevated BP • Pitting & sacral edema • Weight gain • Increased CVP • Change in level of consciousness

  19. Fluid Volume Excess

  20. LAB INVESTIGATION • serum osmolality <275mOsm/ kg • Decreased hematocrit [ < 45%]

  21. MANAGEMENT • Diuretics • Restrict fluids • In people with HF, ACE inhibitors • A low sodium diet

  22. Water intoxication • At the onset of this condition fluid outside the cells has an excessively low amount of solutes in comparison to inside the cells, the fluid shifts through osmosis into the cells in order to balance its concentration. • This causes the cells to swell. In the brain, this swelling increases ICP

  23. features • headache • personality changes • changes in behavior, confusion, irritability • difficulty breathing during exertion • cramping, nausea, vomiting, •  seizures, brain damage, coma or death due to cerebral oedema

  24. Risk factors • Psychiatric conditions-polydipsia • Over replacement of IV fluids • Heat stress

  25. management • Restriction of fluids is sufficient in mild cases • If severe diuretics needed

  26. Thank you!!

More Related