Fluid

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1.

ICF ECF
Inside cell Outside cell
PH: 7.1 (Low PH) {↑ H+} PH: 7.4 (High PH) {↓
H+}
Volume greater (Twice Lower than ICF
than ECF)
Major cation: K+, Mg2+ Na+
Anion: PO43-, SO42-, Cl-, HCO3-.
Lower Na:K ratio. Higher Na:K ratio
Abundent protein Low protein

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2.
Hypertonic solution: cellular dehydration →
cerebral dehydration → coma → death.
Also, ↑ K+ efflux → Hyperkalemia.

Hypotonic solution: Cellular over hydration → ↑

Hydrostatic pr → cerebral edema → coma → death.

ECF [Na+] is the function of water balance.

ECF volume proportionate to body Na+ content.
Body Na+ content is the function of sodium balance.
Volume disorders always means disorder of ECF.
Na+ balance / Na+ content regulated by Aldosterone.

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3. Isotonic fluid:
* 0.9% Nacl. * 5% Dextrose in water (5% DA)
* 5% Dextrose in 0.225% NS
* Ringers lactate / Hartman solution

Hypovolemic cause:
Severe hemorrhage
Secreterory Diarrhea
Loss of intestinal content by fistula, ileostomy
Intestinal obstruction
Polyuric chronic renal failure

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4. Hypertonic fluid:
* 10% DA * 5% Dextrose in NS * 5% dextrose in
0.45% NS * 5% Dextrose in Ringers lactate. * 3%
NaCl

Hypovolemic: Severe diarrhea, Burn, Persistent

vomiting, profuse sweating. Salt loosing nephritis,
Osmotic diuresis, Diuretic abuse, Adrenal
deficiency/collecting duct deficiency

Hypervolemic:
Primary hyperaldosteronism/ Conn’s syndrome,
Cushing syndrome, Sea water intake

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5. Hypotonic fluid: * 0.45% Saline

Hypervolemic:

CCF, Nephrotic syndrome

Hepatic failure
Cirrhosis of liver
Kwashiorkor
Protein loosing enteropathy

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