Dasar-dasar

Terapi Cairan dan Elektrolit

Dendy Maulana
Fisiologi Cairan Tubuh

Kompartemen Cairan Tubuh

Perpindahan Cairan
Kompartemen Cairan Tubuh
Kompartemen Cairan Tubuh
Perpindahan Cairan dan Elektrolit
■ Diffusion
■ Facilitated diffusion
■ Active transport
■ Osmosis
■ Hydrostatic pressure
■ Oncotic (Osmotic colloid) pressure (reabsorption)
“keeping the fluid in”
Perpindahan Cairan - kapiler

Hidrostatic pressure generated by blood pressure

Osmotic pressure generated by dissolved solute

Perpindahan Cairan
Tujuan Terapi Cairan

Mempertahankan volume intravaskuler

Pemeliharaan/maintenance/rumatan

Koreksi elektrolit

Koreksi Asam-basa
Mempertahankan Volume Intravaskuler

Shock is the Restore O2 & perfusion

immediate systemic to prevent sustained
result of inadequate tissue hypoperfusion
O2 delivery in tissue result in organ system
(hypoperfusion) dysfunction and death

Fluid Resuscitation
It must reduce
blood flow to
heart and brain

It induces ischemic injury to

perfusion pressure dependent
organ: Kidney>Gut>Liver

It causes ACTH-mediated release of

hydrocortisone and endorphins

It induces a strong sympathetic response

It abolishes autoregulation of blood flow among

tissue
Mempertahankan Volume Intravaskuler
Mempertahankan Volume Intravaskuler
Pemeliharaan/maintenance/rumatan
Koreksi Elektrolit
Jenis Cairan
Osmolalitas Plasma 285-295
Osmolaritas
Tonisitas
 Jenis Cairan

CRYSTALLOIDS Colloids
Jenis Cairan
CRYSTALLOIDS

Advantages Disadvantages

Cheap Large volume needed

Easy to store and warm Dilutional coagulopathy
Eastablished safety No O2 carrying capacity
Rise in cardiac output May increase ICP
CRYSTALLOIDS
Colloids

Advantages Disadvantages
Smaller volume Renal imparment
Less pulmonary edema Coagulopathy

Stay longer in IV space Anaphylactic reactions

Quicker return to normal hd Cost
Colloids
Ideal resuscitation fluid

1.Predictable and sustained increase in

intravascular volume
2.Chemical composition as close as possible to
that of extracellular fluid
3.Metabolized and completely excreted without
accumulation in tissues
4.Does not produce adverse metabolic or
systemic effects
5.Cost-effective in terms of improving patient
outcomes
Efek Samping Pemberian Cairan

“All Things are poison and nothing is without poison, only

the dose makes a thing not a poison”

Paracelsus (1493-1541)
Efek Samping Pemberian Cairan
Terima Kasih…