icu lecture resuscitation fluid

  • NS high Na and Cl and very acidic

NS

  • 1L: 275 cc to plasma and 825 to interstitium
  • suppresses RAAS and leads to sodium retention. Decrease renal perfusion with chloride mediated vasoconstriction

LR

Plasma Lyte

Albumin

  • 5% is hypotonic. Avoid in head trauma patients. Can lead to cerebral edema
  • 25% is hypertonic

Volume Status

CVP

  • surrogate of LV filling
  • measure of pressure, not volume

PA Catheter

Thermodilution

  • gives end diastolic volume

LV end diastolic area

  • Mean LV is volume depleted. Could be overall low volume or RV heart failure

Pulse Pressure Variation

  • height of A line tracing

Stroke volume variation

  • Vigileo

Passive leg raise

  • evaluate with pocus, a line