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PENDAHULUAN
Kegawatan
Kematian
Diare
Muntah-muntah
Peritonitis
Ileus obstruktif
Puasa
Luka bakar
Perdarahan
60% BB = Air
Is Fluid
IV Fluid
40%
24 L
15%
9L
5%
3L
Dinding kapiler
(sel endothelial)
Permeable thd air
dan molekul kecil
ISF
IVF
Dextrose 5%
RL, NaCl 0.9%
Colloid
-Blood
-Plasma
-Plasma expander
100 ml
2.500 ml
Kebutuhan K + : K + x BB x 0,4
- Kecepatan pemberian max
20 mEq/jam
- atau 200 mEq / 24 jam
- Produksi urine 1 ml / Kg BB / jam
- 1 2 mEq / Kg BB / 24 jam
Kebutuhan Na + : Na + x BB x
0,6
- 2 3 mEq / Kg BB / 24 jam
Pemberian cairan
1.
2.
3.
b)
c)
The Crystalloids
Crystalloids are a group of intravenous fluid in which
may be:
Ionic solution
Ringer lactate/ acetate
NaCl physiologic (0.9% saline)
Hartmans solution
Etc
Mostly iso-osmolar = isotonic
Cheap, easy to manufacture
Has no immunologic reaction
Mainly confined to the extracellular fluid
Non ionic
Dextrose 5%
Maltose 10%
Etc
Distributed to intracellular space
K+
Ca+
Cl-
Plasma
140
Lact Os
ate m.
103
300
Ringer
Lactate
NaCl
130
109
28
273
154
154
308
The Colloids
Colloids are fluids which contain oncotic
particles, therefore exert an oncotic pressure
Blood
Plasma
Albumin
Artificial colloids = plasma expander
Intravenous fluid
Fluid
Dextrose 5%
Crystalloids
Dextrose 5% + NaCl
0.45%
Dextrose 5% in Ringers
RL/ Asering
NaCl 0.45%
NaCl 0.9%
NaCl 0.3%
Manitol 20%
Colloids
Plasma
Albumin 5%
Kanji heta 6% in NaCl
0.9%
40 Dextran 10% in NaCl
Dextros
e
(g/dL)
Na+
(mEq/L
)
ClOsmolarit Oncotic
y
P
(mEq/L
)
(mosmol/L (mmHg)
)
50
50
50
278
77
130
130
77
154
513
154
154
154
77
109
109
77
154
513
154
154
154
405
525
275
154
308
1026
1098
295
290
~310
~310
~310
21
19
31
169
19
Tonicity
Describing the osmolarity of fluid which compared
to the osmolarity of another fluids. Body fluid as a
standard.
Isotonic (RL, NaCl 0.9%, Hartmann)
Hypotonic (NaCl 0.45%)
Hypertonic : - aminovel
- aminofusin
- triofusin
DEHIDRASI
Dehidrasi ringan
( defisit 4% BB )
2.
3.
Dehidrasi berat
4.
( defisit 12% BB )
24
+ 4 L colloids
+ 4 L crystalloids
24
12
+
4
L
dextrose
4
28
24
TERAPI CAIRAN
Rumatan
Resusita
si
Kristalo
id
Koloi
d
Mengganti kehilangan
akut
(Syok, dehidrasi,
hipovolemik)
Air + Elektrolit +
Nutrisi
Memasok
kebutuhan
harian
Rumatan
AIR
30-50
ml
Na
2-4
mEq
KALORI
20-30 Kcal / kg
BB
/ Kg / Hari
K
1-2
mEq
NUTRISI
PROTEIN
0,5-1 gr / kg
BB
Anak-anak
Cairan
Sesuai berat
30-50 cc / Kg BB
badan
Natriu
m
Rumata
n
Normal
asupan
oral
Extra
30-50 ml /
Kg
Demam
IWL
Normal
pengerluara
n urine
25 ml /
Kg
Kehilanga
n
abnormal
Anak
Bayi
Kehilangan
air
42 ml / 100 kal
Kulit = 800 ml
Paru = 400 ml
300-600 ml /
hari
75-300 ml / h
Keringat
10-20 ml / 100
kal (aktifitas
minimal)
50 ml / 100 kal
(aktifitas berat)
Tidak
bermakna
Urine
84 ml / 100 kal
= 1500 ml
90 ml / 100 kal
= 500-800 ml
100 ml / 100
kal = 200-500
ml
4 ml / 100 kal
4 ml / 100 kal
Feses
Dikutip dari : Fluids and Electrolytes, Collins 1996
4 ml / 100 kal
Na
+
K+
Mg
++
Cl -
HPO4
-
Plasma
140
Ringer
Laktat
130
109
28
154
Dextrose
5%
27,0
108
Lakta Dextros
t
e (g/l)
Kalori
(kcal/
l)
TERIMA KASIH