FLUID

MANAGEMENT
FOR ADULTS
AND CHILDREN
 Management fluid include :
Fluid resuscitation, to replace acute loss of
body fluid, that can cause shock. This therapy
is aimed to rapid expantion of intravascular
fluid and improve tissue perfusion.
Maintenance fluid, to maintain balance of
body fluid and nutrition.
TOTAL BODY WATER ( ASHCRAFT )

AGE %

Gestational 12 week 94
12 week 32 week 80
Aterm
3-5 day 78
-3 5
Neonatus 75 - 80
Children 65 - 75
Young Man 60
Young Woman 50
Over 60 years man 50
Over 60 years women 45
 DISTRIBUTION OF BODY FLUID

1.EXTRACELLULAR FLUID 20%

PLASMA 5 %
INTERSTITIAL FLUID 15%
2.INTRACELLULAR FLUID 40%
 FUNCTION OF BODY FLUID
Maintain the temperature of body
Transportation: nutrient to cell, chemical
particles, blood particles, hormone and
residual metabolism.
Lubricant between organs.
Maintain hydrostatic pressure in
cardiovascular system.
 ELECTROLYTES
CHILDREN (Per m2/day) ADULT (per kg BW/day)

NA : 3O mEq NA : 2-2,5 mEq

K : 20 mEq K : 1-1,5 mEq
CL : 30 mEq CL :1,5 mEq
 FLUID AND ELECTROLYTES BALANCE

INPUT OUTPUT

Drink :1000 ml Urine: 1200-1500 ml/hari

Food : 1200 ml Feses: 100 ml
Oxidation : 200-300 Lung: 300-500 ml
ml
Skin: 600-800 ml
 FLUID AND ELECTROLYTES
BALANCE DISORDER
HIPERVOLEMY
The addition or overload conditions of extracellular fluid
volume (CES):
Chronic kidney disorders to sodium and water retention.
Abnormal kidney function, with decreased excretion of
sodium and water
Excess fluid delivery
Interstitial fluid transfer to plasma
HIPOVOLEMY
Conditions that caused by extracellular fluid
volume deficiency (CES), occur due to fluid loss
through the skin, kidney, gastrointestinal,
hemorrhage Hypovolemic shock
 Dehydration (deficit volume)
ISOTONIC, lack of fluid, cause by transport of
fluid from intracellular to extracellular.

HYPERTONIC, lack of electrolytes cause by

transport of fluid from extracellular to
intracellular.
 GRADE OF DEHYDRATION
DEHYDRATION ADULT CHILDREN

MILD
MODERATE

SEVERE
SHOCK
 Determine grade of Dehydration:
Rehydration BW before sick BW after sick

BW before sick

Example : Body weight before sick 50 kg and

after that 47 kg, grade of dehydration?
(50-47) x 100 % = 6 % (Moderate)
50
 REHYDRATION
Mild : drink a lot
Moderate : 75 ml/kgBW/3 hours
Severe :
age : <1 years (30 ml, initial 1 hours )
(70 ml, next 5 hours)
>1 years (30 ml, initial 30 minute)
(70 ml, next 2,5 hours)
 EXAMPLE OF FLUID CALCULATION FOR
INFANT DEHYDRATION

Requirement Amount Kecepatan /hour

30 cc/kgbw 30 x 6 = 180 cc/hour
(1 hour) 180 cc/ 1 hour

70 cc/kg bw (5 70 x 6 = 84 cc/hour
hour) 420 cc / 5 hour
 FLUID CALCULATION FOR CHILDREN

MAINTENANCE ( ASHCRAFT )
Weight Volume

Premature (< 2kg ) 150 ml / kg

Neonatus & infant (2-10 kg ) 100ml/kg for first 10kg
Infant & children (10-20kg ) 1000ml+50ml/kg over 10 kg
Children ( > 20 kg ) 1500ml+20ml/kg over 20 kg
 FLUID CALCULATION FOR ADULT
30-50 cc/Kg BW/24 hour
Example:
Patient bodys weight 50 Kg, how many fluid
requirement in 24 hours?

50 cc x 50 kg = 2500 cc/24 hours

Drip/minute: Amount fluid (cc)
duration (hour)x3
2500 = 35 drip/minute
24 x 3
 EXAMPLE OF FLUID CALCULATION FOR CHILDREN
WITH BODY WEIGHT 25 Kg
HOLIDAY SEGARD (PER 24 HOUR) (PER HOUR)
1st 100 x 10 = 1000 1st 4 x 10 = 40
2nd 50 x 10 = 500 2nd 2 x 10 = 20
3rd 20 x 5 = 100 3rd 1x5 = 5
Amount 1600 cc/24 hours Amount 65 cc/hours= 24 x
65 = 1560 cc/24 hours

Drip /minute: 1600 = 22 drip/minute

24x3
Drip/minute (mikro): Fluid amount (cc) : 1600 = 66 drip/minute
duration (hour) 24
 TYPES OF FLUIDS

Fluids that
is a fluid consist of high
is a fluid consisting consisting of concentration of
of electrolytes and electrolytes electrolytes
macromolecules
CRYSTALLOID vs COLLOID
THANK YOU-