Initial fluid resuscitation + fluid therapy

Question 1

How is sepsis treated?

Answer 1

• immediate

- extra fluids prevent BP from dropping + causing shock

Question 2

How is septic shock treated?

Answer 2

• immediate
  1. ensure tissue perfusion = restore effective intravascular volume
  2. optimize cardiac output

Question 3

What fluid given within 1st 3 hrs ?

Answer 3

crystalloid fluid - 30ml/kg IV

Question 4

What additional fluid administrating using static variables can be used?

Answer 4

• CVP - central venous pressure
• dynamic measures - passive leg raise technique, fluid challenges, pulse pressure variation
• non-invasive - ultrasound - assess intravascular vol measure inferior vena cava
• target blodo lactate levels - elevate blood lactate - marker improved tissue perfusion

Question 5

Use and types of crystalloid fluids

Answer 5

• 0.9% NaCl / Ringers Lactate soln
• resuscitation
• require > fluid vol –> oedema
• caution - CHF, renal failure , ARDS

Question 6

uses and types of colloids

Answer 6

• albumin products
• resuscitation
• > expensive

Question 7

What is used for continued resuscitation?

Answer 7

• balanced crystalloid solns / chloride restrictive strategy

Question 8

What may large volumes of isotonic saline cause?

Answer 8

• AKI

- need for RRT secondary to hyperchloaemic metabolic acidosis