Fluids and

Electrolytes
Elisa Salakay, dr
 We are
approximately
two-thirds
water
 Importance of Homeostasis
• Fluid and electrolyte and Acid-base
balance are critical to health and
well-being

Maintained by intake
and output
Regulation by :
……..renal and pulmonary
Fluid Balance systems
A result of the relationship between body water/fluids, fluid compartments, movement
of fluids, movement of solutes, effect of regulatory mechanisms
 Daily WATER BALANCE
Water intake Water excretion
DRINK
DRINK Vaporization from lungs 400
ml/day
1500
1500 Insensible perspiration
ml/Day
ml/Day 600 ml/day

Insolid
In solid
food800
800 In feces
food 100 ml/day
ml/day
ml/day

METABOLISM
METABOLISM
294ml/day
294 ml/day BODY URINE
1500 ml/day

( Total 2600 ml ) approx ( Total 2600 ml )

Adapted from Goldberger, Water, Electrolyte, Acid base balance.
  Functions of body fluid:
- medium for transport/exchange nutrients
- medium for metabolic needs
- regulation body temperature
- form for body structure
- insulation
- lubrication
 Extracellular space
Nucleus Intracellular
space

Cytoplasm

Cell
Membrane
 Body Fluid Compartments:
Total Body Water ( TBW) = 60% wt ( 70 kg -> 42 L 0 …… varies due to ?

TBW
Extracellular fluid (ECF)
(Internal environment)
Volume= 14 L, 1/3 TBW

Interstitial fluid Plasma

Intracellular fluid volume = 11 L Volume =
3L
80% of ECF
Volume = 28 L, 2/3 TBW 20% of
ECF
Transcellular Fluid ~1% body weight
 includes cerebrospinal, intraocular,
pleural, peritoneal, synovial fluids, and
digestive secretions.
 are surrounded by specialized epithelial
cells, and have specialized compositions.
Water is the largest single component of the body

60% of adult’s weight is

………………water
Water is main solvent in living cells

Distribution/Compartment of Body Fluids

Body Water

Intracellular fluid Extracellular fluid

(inside cells) (outside cells)

Plasma Interstitial Fluid

(inside (outside blood vessels,
blood vessels) Between and around the cells
)
Intravascular volume is the most critical for survival: determinant of blood
pressure, cardiac output, organ perfusion, oxygenation etc.
Water is the “universal solvent”

O -
Na Cl + -

H
+
H
+

Solvent vs Solute
 Composition of body fluids
Solutes are broadly classified into :

Electrolyte Inorganik salts (ie, Na+,K+,Cl-) all

acids and bases and some
proteins

Non Examples includes glucose,

Electrolyte lipids, cretinine and urea

 Electrolytes have greater osmotic power than non-electrolyte, therefore

Electrolites have greatest power to shift fluids
 Water move according to osmotic gradients
 Ionic Composition of Body Fluids
Concentration Units are in mEq/L
(How many grams of electrolyte (solute) in a liter of plasma
(solution)
Cations Anions
140
110
Extracellular 24
More protein
Fluid Na +
Cl HCO3 And more cations
Ca2+ in plasma than
Mg2+ Interstitial fluid
Protein--

K+
Intracellular
Fluid
140

Phosphate and Organic Anions

 Fluid compartments
and Ionic composition
of the major body-
fluid compartments
 Arteriole Intracellular fluid differs from
ECF Extracellular
P

ISF

ICF

Venule

Fig. Diffusion of fluid through the capillary walls and through the interstitial spaces
 Fluid Movement

Exchange between blood and interstitial spaces

 Fluid Movement

Exchange between extracellular fluids and cells

Regulation
and
• Major contributor to
Movement maintaining water
of Sodium balance
(Na) • By effect on serum osmolality,
nerve impulse transmission,
Most abundant regulation of acid-base balance
cation in ECF and participation in chemical
reactions
• Regulated by dietary
Normal level : intake and aldosterone
135-145
Regulation and Functions
Movement – osmotic P within cell
– neuromuscular activity

K+
of – related to movement of
glucose
– acid-base balance
Serum levels maintained
Potassium by:
– dietary ingestion
– renal regulation
Major cation in intracellular the influence of aldosterone
compartments Basal requirement of Potassium
K
K++ intake
intake ranges
ranges from
from 40-150
40-150 mEq
mEq daily
daily
Homeostasis
Homeostasis (minimum
(minimum req)
req) 20-30
20-30 mEq/day
mEq/day
Normal level Increased
Increased requirement
requirement in
in heart
heart failure
failure and
and hypertension
hypertension
(3.5 - 5.0 mEq/L)
KESEIMBANGAN KALSIUM
Dikendalikan scr ketat oleh interaksi :
- Absorbsi gastrointestinal
- Ekskresi ren
- Resorpsi tulang
- Sistem vit D - hormon paratiroid
KESEIMBANGAN MAGNESIUM
• Manusia mengandung sekitar 29 gr :
- 60 % tersimpan di tulang
- di cairan tubuh :
* terutama di CIS (26 mEq/l)
* di CES (1,5-2,5 mEq/l)
• Kofaktor thd reaksi enzimatik spt :
- fosforilasi glukosa dlm sel
- penggunaan ATP pd kontraksi serat otot
- sbg komponen struktural tulang
* Intake 24-32 mEq/l (0,3-0,4 g) per hari
KESEIMBANGAN FOSFAT
• Dibutuhkan utk mineralisasi tulang
• Di cairan tubuh :
- pembentukan energi
- aktivasi enzim
- sintesa asam nukleat
• Konsentrasi di plasma 1,8-2,6 mEq/l
• Direabsorbsi di tub kon proksimal di
rangsang oleh calcitriol
• Keluar mell feses & urin 30-45 mEq/l
per hari
 Condition Initial Change Initial Effect Correction Result
↓ H2O in the ECF ↑ Na+ concentration, ↑ Thirst → ↑ H2O intake ↑ H2O in the ECF
Change in ↑ ECF osmolarity ↑ ADH → ↓ H2O output
OSMOLARITY
(corrected by ↑ H2O in the ECF ↓ Na+ concentration, ↓ Thirst → ↓ H2O intake ↓ H2O in the ECF
change in H2O ↓ ECF osmolarity ↓ ADH → ↑ H2O output
levelsA)

↓ H2O / Na+ in the ↓ Volume Renin-angiotensin: ↑ H2O intake

ECF ↓ BP ↑ Thrist ↑ Na+ / H2O
↑ ADH reabsorption
Change in ↑ Aldosterone ↓ H2O loss
VOLUME ↑ Vasocontriction
(corrected by
change in Na+ ↓ H2O / Na+ in the ↑ Volume Natriuretic-peptides: ↓ H2O intake
leves) ECF ↑ BP ↓ Thrist ↓ Na+ / H2O
↓ ADH reabsorption
↓ Aldosterone ↑ H2O loss

You should understand this table

Thank You
 Tugas Presentasi Kelompok
1. Jelaskan proses terjadinya rasa haus! Kelompok 1 (13 September)
2. Jelaskan proses terjadinya urine! Kelompok 2 (13 September)
3. Jelaskan proses Mikturisi! Kelompok 3 (13 September)
4. Jelaskan mengenai sistem limfatik (fungsi fisiologis dan cara
kerjanya)! Kelompok 4 (20 September)
5. Jelaskan proses terjadinya edema (penyebabnya dan proses yang
terjadi)! Kelompok 5 (20 September)
6. Jelaskan pengaturan keseimbangan asam-basa serta efek asidosis
dan alkalosis pada fungsi tubuh! Kelompok 6 (20 September)

Sertakan video / animasi yang terkait pada presentasi anda!