πππ¨ππ π’π πππ’πππ
Rationale:
π΄Diarrhea leads to loss of both water and electrolytes, especially bicarbonate, causing metabolic acidosis.
π΄RL contains lactate, which is converted to bicarbonate in the liver, helping correct the acidosis.
π΄RL also closely resembles extracellular fluid, making it ideal for volume replacement.
2. Vomiting β Normal Saline (NS)
Rationale:
π΅Vomiting causes loss of hydrogen ions (HCl) from the stomach, leading to metabolic alkalosis.
π΅NS (0.9% NaCl) helps restore chloride and sodium, which helps the kidneys excrete bicarbonate, correcting the alkalosis.
3. Hepatorenal Syndrome (HRS) β Albumin
Rationale:
π‘HRS is a functional renal failure in advanced liver disease.
π‘Albumin, a colloid, expands plasma volume and helps improve renal perfusion by increasing oncotic pressure, especially when combined with vasoconstrictors.
4. Sepsis β Crystalloids
Rationale:
π£Early goal-directed therapy in sepsis includes aggressive fluid resuscitation.
π£Crystalloids (e.g., NS or balanced solutions like RL) are first-line due to wide availability and cost-effectiveness.
π£Helps correct hypovolemia and maintain tissue perfusion.
5. With BT (Blood Transfusion) β Normal Saline (NS)
Rationale:
π’NS is isotonic and does not cause hemolysis of red blood cells.
π’RL contains calcium, which can bind to citrate in stored blood, potentially causing clotting, so it's avoided.
6. Diabetic Ketoacidosis (DKA) β Normal Saline (NS)
Rationale:
π€Initial fluid of choice is NS to correct hypovolemia and electrolyte loss.
π€Once blood glucose reaches around 200β250 mg/dL, fluids may be changed to 5% dextrose with 0.45% saline.
7. Sweating β Β½ Normal Saline (0.45% NaCl)
Rationale:
βͺSweat loss is hypotonic, leading to hypernatremia.
βͺΒ½ NS is also hypotonic, which helps gently lower serum sodium and replenish lost fluid.
8. Head Injury β Hypertonic Saline (HS) > Normal Saline (NS)
Rationale:
β«Hypertonic saline (e.g., 3% NaCl) reduces intracranial pressure (ICP) by drawing fluid out of the brain via osmosis.
β«NS can be used, but HS is preferred in raised ICP scenarios.
Comments
Post a Comment