fluid

Crystalloids

normal saline

first reported by Hamburger
Consequent of ↑Cl content:
- renal vasoconstriction
- ↓renal blood flow
- ↓GFR, diuresis
- ↓RAAS
suitable for pyloric stenosis

Balanced solution: isotonic, isoionic, isohydric

Ringer's solution

first described in 19th century by Sydney Ringer
modified by Alexis Hartmann et al from St louis
- adding sodium lactate to prevent metabolic acidosis

compared to Lactate, acetate metabolism is significantly faster & more independent of hepatic function, w/ a lower ↑ in O2 consumption & no interference w/ diagnostic use of Lactate as marker of inadequate tissue perfusion

Colloids

interfere w/ coagulation
- measurable changes of TEG parameters from dosage of 10-15ml/kg
impair renal function

HES

causing renal impairment

gelatin

?higher allergenic potential

albumin

comprises >50% of plasma proteins
responsible for 80% of intravascular oncotic pressure
main regulator of vascular barrier
antioxidant in plasma
transporter of nitric oxide, fatty acids, drugs
anticoagulant & antithrombotic functions
extracted from human blood
- virus safe
most expensive colloid besides plasma

References

Update on Perioperative Fluids