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Februar 2023
eBook (PDF)
Rolf Zander
Fluid Management
Second expanded (corrected) edition
The multicolor PDF contains 6 tables, 15 color images and 421 alphabetical references from 1948 to 2008.
The advantage of the PDF format is the search function, i.e. one can search the entire book using any keyword.
This lack of interest in the composition of intravenous fluids among the medical profession has for decades been causing substantial problems in fluid management resulting from clinicians’ failure to differentiate between the concepts of volume replacement and fluid replacement. At the turn of the century only 1 % of anesthetists in the 6th year knew the correct composition of 0.9 % NaCl and Ringer's lactate (White et al. 1997).
Fluid replacement aims to offset or compensate for an impending or existing extracelluar volume deficit as a result of cutaneous, enteral, or renal fluid loss. This is achieved with an essentially physiological solution that contains all osmotically active components, i.e., an isotonic fluid.
Volume replacement, however, aims to replace intravascular volume, and to correct hypovolemia in order to maintain hemodynamics and vital signs. This is achieved with an essentially physiological solution that contains both colloid osmotic and osmotic components, i.e., a fluid that is both isooncotic and isotonic.
The limitation of any volume replacement therapy is reached once hemodilution has reduced the oxygen carrying capacity of the blood to the point where organs and tissues can no longer be adequately supplied with O₂. Then hemotherapy follows.
The advantage of the PDF format is the search function, i.e. one can search the entire book using any keyword.
This lack of interest in the composition of intravenous fluids among the medical profession has for decades been causing substantial problems in fluid management resulting from clinicians’ failure to differentiate between the concepts of volume replacement and fluid replacement. At the turn of the century only 1 % of anesthetists in the 6th year knew the correct composition of 0.9 % NaCl and Ringer's lactate (White et al. 1997).
Fluid replacement aims to offset or compensate for an impending or existing extracelluar volume deficit as a result of cutaneous, enteral, or renal fluid loss. This is achieved with an essentially physiological solution that contains all osmotically active components, i.e., an isotonic fluid.
Volume replacement, however, aims to replace intravascular volume, and to correct hypovolemia in order to maintain hemodynamics and vital signs. This is achieved with an essentially physiological solution that contains both colloid osmotic and osmotic components, i.e., a fluid that is both isooncotic and isotonic.
The limitation of any volume replacement therapy is reached once hemodilution has reduced the oxygen carrying capacity of the blood to the point where organs and tissues can no longer be adequately supplied with O₂. Then hemotherapy follows.
Schlagwörter: Fluidtherapy; Volumetherapy
Über den Autor:
Prof. Dr. med. Rolf Zander was born 1942 in Braunschweig (Brunswick, Germany). He studied medicine and became a physician (i.e., residency, fellowship, medical education). From 1970 until his retirement in 2007 he worked at the Institute of Physiology and Patho-physiology at the University at Mainz, Germany. There, his academic track included years as a reader at professorial level until his appointment to the life-time professorship of Physiology in 1978. Now he led a working group dealing with questions of clinical physiology, particularly regarding respiration, blood products, and hemodilution. In context with a variety of developments he also designed special infusion solutions for clinical use. Simultaneously to the retirement in 2007 he established a private scientific open access portal Physioklin.de für clinical physiology.
DOI 10.2370/9783844089844
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