INTRAVENOUS FLUIDS: 'THE PRESCRIPTION' BASED ON THE PATIENT'S PROFILE

摘要

As you review the various illnesses your patients have, you will see how the acid-base and electrolyte status of the patient can direct fluid therapy. It is essential to "prescribe" the appropriate fluid and electrolyte therapy to enhance recovery andprevent deterioration. The history and physical examination is also an important part of the "equation" when making this assessment. Many conditions are associated with alterations in the metabolic status of a patient, for example, diabetic ketoacidosismay result in profound acidosis, while upper gastrointestinal vomiting is frequently associated with alkalosis, and both may be associated with compensatory mechanisms. As a brief review, the terms "acidosis" (acidotic) and "alkalosis" (alkalotic) referto the pathophysiological process that causes a net accumulation of an acid or alkali in the body. The terms "acidemia" and "alkalemia" refer to the pH of the blood; therefore, the patient would be acidemic if the underlying problem resulted in acidosisdue to FT gain or HC03" loss, or alkalemic with FT loss or HC03 gain.