Fluid replacement: Difference between revisions
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'''Fluid replacement''' or fluid resuscitation is the medical practice of replenishing bodily fluid lost through sweating, bleeding, fluid shifts or other pathologic processes. Fluids can be replaced via oral administration (drinking), intravenous administration, or ''hypodermoclysis'', the direct injection of fluid into the subcutaneous tissue. Fluids administered by the oral and hypodermic routes are absorbed more slowly than those given intravenously. |
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In severe [[dehydration]], intravenous fluid replacement is preferred, and may be lifesaving. Physiologic [[Sodium chloride|normal saline]], or 0.9% [[sodium chloride]] solution, is often used because it is [[isotonic]], and therefore will not cause potentially dangerous ''fluid shifts''. If given intravenously, normal saline remains in the circulation, boosting [[blood pressure]] and preventing the complications of inadequate [[Circulation (physiology)|circulation]]. |
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''Fluid shifts'' occur when the body's fluids move from the intracellular space into the intravascular space, or vice versa. Many medical conditions can cause fluid shifts. When fluid moves out of the intravascular space (the blood vessels), blood pressure can drop to dangerously low levels, endangering critical organs such as the [[brain]], [[heart]] and [[kidney]]s. When fluid shifts out of the cells (the [[intracellular space]]), cellular processes slow down or cease from intracellular dehydration. |
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'''[[Third Spacing|The third space]]''' where bodily fluid resides is the [[interstitial space (biology)|interstitial space]], or the space filled with [[interstitial fluid]] between the cells within the tissues. Depletion of this space is not life threatening, and usually accompanies depletion of the other spaces. Extensive tissue swelling occurs when the [[Third Spacing|third space]] fills with excess fluid. If this process robs the intracellular and intravascular spaces of fluid volume, a type of [[Shock (circulatory)|shock]] called distributive shock ensues. Severe allergic reactions are an example of this type of shock. [[Sepsis]] and some neurologic conditions can also cause distributive shock, although by other mechanisms. |
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''Third space'' is also a term used to refer to, for example, the bowel with an [[ileus]], and the collection of fluid therein, usually post-operatively. The interstitial space could be considered to be a sub-section of the [[extracellular|extracellular compartment]]. The distinction one could make is that fluid in the interstitium is still readily available to either the intravascular or the intracellular compartments, in response to ionic changes, whereas that which is pooled in the bowel is not so readily available. Hopefully someone can clarify this point.'' |
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Bleeding, extensive burns and excessive sweating (as from a prolonged fever) deplete both the intracellular and the vascular spaces. Immediate swift replenishment of fluid via an [[intravenous]] line (or several) is required. Initial treatment of trauma and [[burn victim]]s places high priority on aggressive fluid replacement to maintain organ perfusion. |
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==See also== |
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*[[Hypodermoclysis]] |
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*[[Intravenous therapy]] |
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*[[Hypovolemia]] |
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*[[Third Spacing]] |
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*[[Pentastarch]] |
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[[Category:Medical treatments]] |
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