scholarly journals Basic principles of infusion therapy: fundamentals of fluid and electrolyte balance

2020 ◽  
pp. 196-198
Author(s):  
N.V. Maliutina
Keyword(s):  
Fluid Balance ◽  
Blood Circulation ◽  
The Body ◽  
Infusion Therapy ◽  
Electrolyte Balance ◽  
Oral Rehydration ◽  
Wide Range ◽  
Circulation Parameters ◽  
Effective Doses ◽  
Polyatomic Alcohols

Background. Infusion therapy (IT) is a method of managing the functions of the organism by influencing purposefully the morphological composition and physiological properties of blood through parenteral administration of organic and inorganic solutions. The main feature of IT is that the drug completely enters the bloodstream. Objective. To describe the main characteristics of fluid and electrolyte balance and the IT principles. Materials and methods. Analysis of the literature sources on this topic. Results and discussion. Fluid comprises about 60 % of the human body (in children – 70-80 %, in adults – 60 %, in elderly – 50-55 %). Total fluid includes intracellular and extracellular. The latter, in turn, is divided into intravascular, interstitial and transcellular. Water balance involves the balance of fluid entering the body and the fluid being excreted. The main sources of water are beverages and food, however, about 300 ml per day is formed endogenously during oxidation processes. The main ways of the fluid excretion are its excretion in urine and stool, and perspiration losses. To calculate the physiological need of water for an adult, the body weight should be multiplied by the coefficient of 30 (up to 65 years), 25 (65-75 years) or 20 (more than 75 years). IT should also take into account the pathological losses of water from fever, vomiting, diarrhea, the presence of large wounds or burns, as well as reduction of the need in water in renal or heart failure. Thus, physiological needs, fluid deficiency, fluid volume as a result of pathological loss should be added, and the oral rehydration subtracted from this sum to calculate IT volume. There are 3 degrees of dehydration severity: I degree – deficiency of 1-2 liters, thirst, oliguria; II degree – deficiency of 4-5 liters, thirst, oliguria, dry skin, mucous membranes and tongue, general weakness; III degree – deficiency of 7-8 liters, consciousness disorders, decrease in arterial pressure, shock. The first degree can be overcome by oral rehydration, the second degree – by 50 % of oral rehydration and 50 % of IT, the third degree – by 70-100 % of IT. IT solutions are divided into crystalloids, colloids, polyatomic alcohols and special drugs. Preparations of polyatomic alcohols include, in particular, Reosorbilact, Sorbilact, Xylate (“Yuria-Pharm”). Complications of IT are divided into complications associated with the violation of the technique of entering the bloodstream (injuries of blood vessels and adjacent organs, hematomas, foreign bodies in the vessels and heart, the solution misplacement out of the vascular space); complications associated with the violation of the technique of drug administration (thromboembolism, air and fat embolism); complications associated with the wrong rate of solutions’ administration (heart overload, hypervolemia, pulmonary edema, cerebral edema); complications associated with the characteristics of infusion solutions (partial hemolysis of blood cells, acid-base imbalance, disorders of blood osmolarity, local cooling of the heart); complications associated with the IT method; complications due to individual intolerance; infectious complications in case of violation of asepsis and antiseptics; infectious diseases. Criteria for IT security include the knowledge of the drug composition and understanding of the instructions for its use; multicomponentity; use of the minimum effective doses; monitoring of the excreted urine and other fluids and infused solutions; strict control of fluid balance and blood circulation parameters. Conclusions. 1. IT is an important tool in treatment of many diseases, which performs a wide range of tasks. 2. The IT solution should be chosen depending on the individual needs of the patient. 3. Criteria for IT safety include the knowledge of drug composition and instructions for its use; multicomponentity; use of the minimum effective doses; monitoring of excreted urine and infused solutions; control of fluid balance and blood circulation parameters.

Fluid balance

2014 ◽  
Author(s):  
Anthea Hatfield
Keyword(s):  
Pulmonary Oedema ◽  
Cardiac Failure ◽  
Fluid Balance ◽  
Fluid Overload ◽  
The Body ◽  
Electrolyte Balance ◽  
Fluid Deficit ◽  
Different Types ◽  
Extra Cellular Fluid ◽  
Fluid Compartments

This chapter will tell you how surgery affects fluid balance and how the body controls fluids. Fluid compartments in the body and the nature of fluids are described. Disorders of fluid balance, the use of fluids to restore blood volume, and extra cellular fluid volume are all discussed. Management of fluid deficit, fluid overload, and pulmonary oedema and how to correct electrolyte balance are all clearly set out. Recommendations for fluids after different types of surgery and fluids for patients with renal and cardiac failure are given.

scholarly journals THE HEMOFILTRATION AT INFUSION THERAPY OF SEVERE ACUTE PANCREATITIS

2018 ◽  
Vol 24 (3) ◽  
pp. 120-123
Author(s):  
Andrey N. Ganert ◽  
E. V Kokorev ◽  
P. S Zhbannikov ◽  
A. V Zabusov
Keyword(s):  
Acute Pancreatitis ◽  
Arterial Hypertension ◽  
Severe Acute Pancreatitis ◽  
Fluid Balance ◽  
Blood Circulation ◽  
Optimal Level ◽  
Infusion Therapy ◽  
Positive Fluid Balance ◽  
Frequent Application ◽  
Cumulative Fluid Balance

The 64 patients with severe acute pancreatitis at admission in hospital arterial hypertension, low venous saturation of oxygen (ScvO2), hyperlactemia, oligoanuria and hypercreatininemia were observed. This occurrence became an indication for infusion therapy to recover and optimize hemodynamics. After 6 hours of therapy, 30 patients were lacked increasing of diuresis related to infusion load and hypercreatininemia increased and also significantly increased positive fluid balance s compared to other patients. These 30 patients were additionally applied hemofiltration during 66 hours. The infusion therapy was characterized by difficulty of restoration and optimization of hemodynamic, large volumes of infusion mediums та frequent application of sympathomimetics. In patients without hemofiltration a significant increasing of cumulative fluid balance was added. The hemofiltration permitted to normalize diuresis, to prevent surplus cumulation of fluid and to support blood circulation at the optimal level.

scholarly journals Complications of the infusion therapy and their prevention

2020 ◽  
pp. 45-47
Author(s):  
O.A. Halushko
Keyword(s):  
Side Effects ◽  
Infusion Rate ◽  
Interstitial Space ◽  
Infusion Therapy ◽  
Electrolyte Balance ◽  
Minimal Risk ◽  
Advantages And Disadvantages ◽  
Ringer’S Solution ◽  
Filling Time ◽  
Polyatomic Alcohols

Background. Infusion solutions are divided into several groups: crystalloids, colloids (natural and artificial), polyatomic alcohols, special drugs (infusion antibiotics, analgesics, hemostatics). Each solution type has its own complications. Objective. To identify the main complications of infusions and prevention measures. Materials and methods. Analysis of the available literature on this topic. Results and discussion. After the transfusion of 1 liter of 0.9 % NaCl only 275 ml of this solution remains in plasma, and 725 ml passes into the interstitial space, causing edema. In addition, there is a risk of hyperchloraemic acidosis in case of massive transfusions. 0.9 % NaCl is inadequate in its ionic composition, has no reserve alkalinity, deepens hyperosmolar changes, so it is not used as monotherapy in daily practice. It is used as a solvent only. Ringer’s solution is also easily excreted into the interstitial space with the edema formation. It is hyperosmolar, contains a large number of chlorine ions and is excreted by the kidneys, so it should be used with caution in patients with kidney disease. A number of drugs (aminocaproic acid, amphotericin B, blood products, sodium thiopental) are incompatible with Ringer’s solution and Ringer’s lactate. In turn, 5 % glucose solution is ineffective for detoxification, liver cirrhosis and restoring the circulating blood volume in case of blood loss. Glucose infusions can increase the production of carbon dioxide and lactate, increase ischemic damage to the brain and other organs, and promote tissue edema. At present, the routine use of glucose during surgery and in critically ill patients has been completely abandoned. Preparations of polyatomic alcohols can be divided into the preparations of six-atomic alcohols – mannitol (Mannit) and sorbitol (Sorbilact, Reosorbilact) and five-atomic alcohols (xylitol – Xylate, Gluxyl, Lactoxyl) (all of the listed solutions are made by “Yuria-Pharm”). Side effects of mannitol include tachycardia, thrombophlebitis, chest pain, skin rash, dehydration, dyspepsia, fluid and electrolyte balance, and hallucinations. Hypotension is the most common complication of mannitol usage. Reosorbilact is a modern balanced infusion solution. Its effects include the hypovolemia correction, restoration of electrolyte disturbances, normalization of cardiac activity and nerve conduction, increase of alkaline blood reserve and restoration of energy balance. In case of the significant overdose Reosorbilact can cause alkalosis. Contraindications to its administration include alkalosis, cerebral hemorrhage, pulmonary embolism, and 3 grade hypertension. Xylitol is a five-atom alcohol that is rapidly incorporated into the pentose phosphate metaboliс pathway. Its side effects include the allergic reactions, hypertension, nausea, and lactic acidosis. The main disadvantage of hydroxyethyl starch (HES) drugs is the adverse effect on hemostasis (especially in drugs of the first generation). In addition, HES may impair the renal function, so they should be used in the lowest effective dose for the shortest period of time. In addition to complications associated with infusion solutions, there are complications associated with the injection procedure (hematoma, infiltration, thromboembolism, air embolism, and phlebitis). The thorough monitoring is needed to prevent the complications of all stages of infusion therapy. Such parameters as blood pressure, heart rate, blood gas composition, capillary filling time, mental status, and diuresis should be monitored. It is also necessary to carefully examine the composition of prescribed drugs and instructions for their medical use, to control the infusion rate, and to combine different drugs rationally. Conclusions. 1. There are several classes of infusion solutions, and each of them has its own advantages and disadvantages. 2. Reosorbilact is a balanced drug with the minimal risk of side effects. 3. To prevent complications, it is necessary to monitor the basic physiological parameters, to control the infusion rate, and to rationally combine different tools.

Fluid balance

2020 ◽  
pp. 353-362
Author(s):  
Anne Craig ◽  
Anthea Hatfield
Keyword(s):  
Pulmonary Oedema ◽  
Blood Volume ◽  
Cardiac Failure ◽  
Fluid Balance ◽  
Fluid Overload ◽  
The Body ◽  
Electrolyte Balance ◽  
Fluid Deficit ◽  
Extra Cellular Fluid ◽  
Fluid Compartments

This chapter will tell you how surgery affects fluid balance and how the body controls fluids. Fluid compartments in the body and the nature of fluids are described. Disorders of fluid balance, the use of fluids to restore blood volume, and extra cellular fluid volume are all discussed. Management of fluid deficit, fluid overload, and pulmonary oedema and how to correct electrolyte balance are all clearly set out. Recommendations for fluids after different types of surgery and fluids for patients with renal and cardiac failure are given.

scholarly journals Correction of electrolyte balance in surgical patients with urgent surgical interventions

2021 ◽  
Vol 25 (4) ◽  
pp. 620-622
Author(s):  
P. I. Bignyak
Keyword(s):  
Acute Appendicitis ◽  
Postoperative Period ◽  
Oral Rehydration Therapy ◽  
Electrolyte Imbalance ◽  
Surgical Patients ◽  
Infusion Therapy ◽  
Control Group ◽  
Electrolyte Balance ◽  
Oral Rehydration ◽  
Postoperative Therapy

Annotation. Acute appendicitis is one of the most common acute pathologies of the abdominal cavity, which requires immediate surgical intervention and can lead to water-electrolyte imbalance. The aim of the study was to investigate the clinical significance of electrolyte imbalance in patients operated on for acute appendicitis and their correction. We examined 20 urgent surgical patients who were part of the control group and received “traditional” postoperative therapy and 23 patients of the study group who received oral rehydration therapy in the postoperative period to correct water-electrolyte disorders. To analyze the results of the study, profile analysis was used as a modification of multidimensional covariance analysis with repeated measurements. As can be seen from the results of testing the hypothesis of normalization of homeostasis due to the use of oral rehydration therapy schemes, the hypothesis was confirmed with a threshold significance of p=0.0642. The only significant effect of the rate of normalization of potassium concentration in blood plasma is the appointment of oral rehydration therapy with p=0.045. Also, the appointment of oral rehydration therapy is a significant effect of the rate of normalization of sodium and glucose in plasma (normalization of plasma glucose is significantly better in the dynamics of younger patients (p=0.045)). Thus, normalization of potassium and glucose, which correlates with the patient's age, was better in patients receiving oral rehydration mixture in the postoperative period than in patients receiving “traditional” postoperative therapy. Oral rehydration therapy is an acceptable alternative to infusion therapy in patients undergoing surgery for acute appendicitis in the postoperative period.

scholarly journals STUDY OF RESULTS BETWEEN INITIAL AND FINAL SPECIFIC TESTS IN WOMEN WITH NORMAL PREGNANCY

2019 ◽  
Vol 17 (2) ◽  
pp. 135-142
Author(s):  
Ir. Nesheva
Keyword(s):  
Pregnant Women ◽  
Blood Circulation ◽  
Vital Capacity ◽  
Clinical Status ◽  
Normal Pregnancy ◽  
The Body ◽  
Functional Tests ◽  
Circulation Parameters ◽  
Processing Information ◽  
Program Content

PURPOSE: The aim of this study was to achieve a control model of basic functional indicators established by comparative analysis between the results of initial and final anthropometric and functional tests in women with normal pregnancy. METHODS: The research was done among 112 individuals, all Bulgarians, in the period 2015-2018, ages 21 to 31 years old. In order to fulfil the aim of the research we used: functional tests for assessing the effects of our original program build for the specific needs of pregnant women. The program content was branded under our family name: “Gym program for pregnant women Nesheva” and was validated in our doctoral thesis and then published in a book (under patent). RESULTS: During our original gymnastics program was registered data by specific tests and the analysis has shown that the average values (Mean ± SD) of the measured parameters, in the three periods of time (during the pregnancy) are statistically different (p <0.05), which is a natural process resulting from the changes taking place in the body of the woman with the progression of pregnancy. These values are interpreted as optimal prenatal weight gain, but probably gymnastics for pregnant women also favour the maintenance of normal values. Studied indicators are presented with the results of the Mean ± SD of the blood circulation parameters and the vital capacity of the pregnant women. CONCLUSIONS: The results in our study are in support to establishing a system for collecting and processing information on the clinical status, general and functional characteristics of pregnant women is a reliable basis for validating standards for regulated inclusion in physical activity programs in normal pregnancy. Indicators of blood circulation and vital capacity in relative resting conditions of pregnant women when enrolled in the gymnastics program are within the limit of normal.

scholarly journals Infusion therapy for sepsis

2020 ◽  
pp. 55-56
Author(s):  
F.S. Glumcher
Keyword(s):  
Cardiac Output ◽  
Fluid Balance ◽  
Clinical Condition ◽  
Fluid Overload ◽  
Colloid Solution ◽  
Infusion Therapy ◽  
Electrolyte Balance ◽  
Close Monitoring ◽  
Organ Perfusion ◽  
Acid Base

Background. Sepsis is a life-threatening organ dysfunction syndrome caused by the dysregulatory response of the organism to infection. Treatment of septic shock (SS) requires massive infusion therapy (IT), as it is necessary to restore volemia as quickly as possible. Other goals of IT are the restoration of electrolyte balance, normalization of acid-base state and organ perfusion. Objective. To describe IT in sepsis. Materials and methods. Analysis of literature sources on this topic; own multicenter prospective open research. 68 patients with abdominal SS source (intestinal obstruction, perforation of hollow organs, infected pancreatitis, etc.) who underwent IT were involved. Results and discussion. In case of SS it is obligatory to start infusion of crystalloid solutions in a dose of 30 ml/kg during the first 3 hours of resuscitation. Current treatment guidelines suggest early aggressive fluid recovery within 6 hours of onset of shock. Delaying an increase in volemia cannot be allowed. If stabilization of the clinical condition cannot be achieved by initial fluid resuscitation, close monitoring should be initiated to avoid fluid overload, as both hypovolemia and hypervolemia increase mortality. Indicators such as blood pressure, heart rate, central venous pressure, dynamic parameters (lower extremity lifting test (LELT), volume load bolus test), lactate content, daily fluid balance should be monitored. Achieving a negative fluid balance during at least one of the first 3 days of SS treatment is a predictor of the favorable prognosis. According to the own study, LELT showed a weak correlation with the results of the infusion probe. This may be related to the increase in intra-abdominal pressure in the studied patients. Despite a number of disadvantages, crystalloids are the basis of SS treatment. The use of hydroxyethyl starch solutions in sepsis is not recommended; they can be used only in limited groups of patients. Albumin is the only safe colloid solution that can be used in patients with SS and hypoalbuminemia, but there is no evidence of the benefits of its routine use in sepsis. Analysis of patient data divided into Reosorbilact, Volutenz, Ringer malate and 0.9 % NaCl (all solutions – “Yuria-Pharm”) found that the most effective solutions for cardiac output were Reosorbilact and Volutenz. Conclusions. 1. Treatment of sepsis and SS requires massive IT. 2. The goals of IT include the restoration of volemia, normalization of electrolyte balance and acid-base status, normalization of organ perfusion. 3. During the first 3 hours of resuscitation in SS, it is advisable to restore the fluid volume within 6 hours from the onset of shock. 4. If stabilization of the clinical condition has not been achieved, close monitoring should be initiated to avoid fluid overload. 5. The most effective solutions for the increase of cardiac output are Reosorbilact and Volutenz.

scholarly journals A Survey of Organ Equivalent and Effective Doses from Diagnostic Radiology Procedures

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Ernest K. Osei ◽  
Johnson Darko
Keyword(s):  
Effective Dose ◽  
Conventional Radiography ◽  
The Body ◽  
X Rays ◽  
Tube Potential ◽  
Wide Range ◽  
Patient Size ◽  
Effective Doses ◽  
Weighted Measure ◽  
Radiological Examinations

The quantification of radiation risks associated with radiological examinations has been a subject of interest with the increased use of X-rays. Effective dose, which is a risk-weighted measure of radiation to organs in the body associated with radiological examination, is considered a good indicator of radiological risk. We have therefore investigated patient effective doses from radiological examinations. Organ and effective doses were estimated for 94 patients who underwent computed tomography examinations and for 338 patients who had conventional radiography examinations. The OrgDose (version 2) program was used for the estimation of effective doses. The tube potential ranges: 57 kVp to 138 kVp depending on the examination and patient size. The entrance surface doses have a wide range even for the same examination: 0.44–10.31 mGy (abdomen) and 0.66–16.08 mGy (lumbar spine) and the corresponding effective dose ranges 0.025–0.77 mSv and 0.025–0.95 mSv respectively. Effective dose for adult abdomen-pelvic CT examinations ranges 5.4–19.8 mSv with a mean of 13.6 mSv and for pediatrics ranges 2.1–5.5 mSv with a mean of 2.7 mSv. The mean effective dose for adult chest and head CT examinations are 7.9 and 1.8 mSv respectively and for pediatrics are 1.7 and 1.1 mSv.

Justification of the need to improve the legal, regulatory and methodological framework for the spread of parasitic infections in the provision of medical care

2020 ◽  
Vol 99 (5) ◽  
pp. 493-497
Author(s):  
M. M. Aslanova ◽  
T. V. Gololobova ◽  
K. Yu. Kuznetsova ◽  
Tamari R. Maniya ◽  
D. V. Rakitina ◽  
...  
Keyword(s):  
Medical Care ◽  
Research Work ◽  
Hospital Environment ◽  
Parasitic Infections ◽  
Infusion Therapy ◽  
Methodological Framework ◽  
Production Environment ◽  
Medical Institutions ◽  
Medical Network ◽  
Wide Range

Introduction. The purpose of our work was to justify the need to improve the legislative, regulatory and methodological framework and preventative measures in relation to the spread of parasitic infections in the provision of medical care. There is a wide range of pathogens of parasitic infestations that are transmitted to humans through various medical manipulations and interventions carried out in various medical institutions. Contaminated care items and furnishings, medical instruments and equipment, solutions for infusion therapy, medical personnel’s clothing and hands, reusable medical products, drinking water, bedding, suture and dressing materials can serve as a major factor in the spread of parasitic infections in the provision of medical care. Purpose of research is the study of the structure and SMP of parasitic origin, circulating on the objects of the production environment in multi-profile medical and preventive institutions of stationary type in order to prevent the occurrence of their spread within medical institutions. Material and methods. The material for the study was flushes taken from the production environment in 3 multi-profile treatment and prevention institutions of inpatient type: a multi-specialty hospital, a maternity hospital and a hospital specializing in the treatment of patients with intestinal diseases for the eggs of worms and cysts of pathogenic protozoa. Results. During the 2-year monitoring of medical preventive institutions, a landscape of parasitic contamination was found to be obtained from the flushes taken from the production environment objects in the premises surveyed as part of the research work. Discussions. In the course of research, the risk of developing ISMP of parasitic origin was found to be determined by the degree of epidemiological safety of the hospital environment, the number and invasiveness of treatment and diagnostic manipulations and various medical technologies. Conclusion. It is necessary to conduct an expert assessment of regulatory and methodological documents in the field of epidemiological surveillance and sanitary and hygienic measures for the prevention of medical aid related infections of parasitic origin, to optimize the regulatory and methodological base, to develop a number of preventive measures aimed at stopping the spread of parasitic infections in the medical network.

Creating the Wind

2020 ◽  
Vol 2 (4) ◽  
pp. 14-31
Author(s):  
Élodie Dupey García
Keyword(s):  
Indigenous Communities ◽  
The Body ◽  
Historical Sources ◽  
Natural Behavior ◽  
Sensory Experiences ◽  
Identity And Agency ◽  
Wide Range ◽  
Late Postclassic ◽  
Comparative Examination ◽  
Meteorological Phenomenon

This article explores how the Nahua of late Postclassic Mesoamerica (1200–1521 CE) created living and material embodiments of their wind god constructed on the basis of sensory experiences that shaped their conception of this divinized meteorological phenomenon. In this process, they employed chromatic and design devices, based on a wide range of natural elements, to add several layers of meaning to the human, painted, and sculpted supports dressed in the god’s insignia. Through a comparative examination of pre-Columbian visual production—especially codices and sculptures—historical sources mainly written in Nahuatl during the viceregal period, and ethnographic data on indigenous communities in modern Mexico, my analysis targets the body paint and shell jewelry of the anthropomorphic “images” of the wind god, along with the Feathered Serpent and the monkey-inspired embodiments of the deity. This study identifies the centrality of other human senses beyond sight in the conception of the wind god and the making of its earthly manifestations. Constructing these deity “images” was tantamount to creating the wind because they were intended to be visual replicas of the wind’s natural behavior. At the same time, they referred to the identity and agency of the wind god in myths and rituals.

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