Post on 06-Sep-2015
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BODY FLUIDS BALANCEAtan Baas Sinuhaji Department of ChildHealthSchool of Medicine,University Of Sumatera Utara Medan
FLUIDS AND ELECTROLYTES BALANCE
BODY FLUIDS BALANCE (PEDIATRICS)
BODY FLUIDSSOLVENTSDISSOLVED SUBSTANCES:WATERELECTROLYTESGLUCOSE PROTEINFATGASES (O2, CO2)
BODY FLUIDSBARRIER/PROTECTIVE CUSHIONTRANSPORTCSFLUBRICANTSYNOVIAL FLUIDSSOLVENTSREACTANTHYDROLYSISTEMPERATUREDEHYDRATION FEVER
1. VOLUME2. DISTRIBUTION3. COMPOSITION OF ELECTROLYTES4. TONICITY5. pHREGULATIONEQUILIBRIUM
TBW(60-70%)ICF : 40 - 45%ECF : 20 - 25%ISF15%PLASMA5%Trancelluler1-3%
THE DIFFERENCES BETWEEN PEDIATRICS AND ADULT BODY FLUIDS 1.TBW PEDIATRICS >ADULT(60 - 70%)(50 - 55%)2. ECF : ICFNEONATES = 1 : 1CHILDHOOD = 2 : 3ADULT = 1 : 23. DAILY TURNOVER OF WATERINFANT = 25% TBWADULT = 6% TBW
INFANTS ARE SUSCEPTIBLE TO THESE DISORDERS 1. DAILY TURNOVER OF WATER >>2. INFANT IS MORE SUSCEPTIBLE THAN ADULT DIARRHOEA, VOMITING3. HOMEOSTASIS MAY NOT BE AS WELL DEVELOPED
INFANT 7 kgECF = 1400 mLINTAKE= 700 mL/dayOUTGO= 700 mL/day
ADULT 70 kgECF= 14 LINTAKE= 2 L /dayOUTGO = 2 L/day
VOLUME Renal Blood Flow RENIN ALDOSTERON H2O & Na+ RETENTION
VOLUME VOLUMERECEPTORSTHIRST CENTREADH (Antidiuretic Hormone)WATER INTAKE WATER RETENTION
TONICITY DILUTION OF ECFTHIRST CENTEROSMORECEPTORSADH WATER INTAKETONICITY
OSMOTIC PRESSURE(290 mOsm/L)Na+ = 135 mEQ/LBUN (Blood Urea Nitrogen)GLUCOSE
INTAKETHIRST CENTREOSM 30 mL / kgBW / dayVOLOUTPUTABSORPTIONSTOOLKIDNEYSSKIN & LUNGS10 mL / kgBW / day60 mL / kgBW / dayREGULATION ALDOSTERON ADH
HOLLIDAY - SEGAR 10 kg100 mL / kg 10 - 20 kg1000 mL + 50 mL/ kg for each > 10 kg > 20 kg1500 mL + 20 mL/ kg for each > 20 kg NB : 100 mL 2,5 mEq Na+ 2 mEq K+ 100 calori
OSMOLALITY VOLUME ADH REABSORPTION OF WATER IN THE DISTAL TUBULES & COLLECTING DUCTS
OSMOLALITY VOLUME ADH VOLUME IS THE 1ST
DISTRIBUTION OF WATERI VFCAPILLARY WALLSISFSTARLING FORCESICFTONICITYCELL WALLSNa+ECF
STARLING FORCES: BALANCE OF HYDROSTATIC PRESSURE & ONCOTIC PRESSUREONCOTIC PRESSUREPLASMA PROTEINALBUMIN
S LAW OF THE HEART RELATION OF TENSION TO LENGTH IN CARDIAC MUSCLE FORCES DISTRIBUTION OF WATER BETWEEN INTERSTISIAL & INTRAVASKULAR
STARLING
COMPOSITION OF ELECTROLYTESECFICFNa+>