Balanscairanelektrolit 141129025203 Conversion Gate02
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BALANS CAIRAN,ELEKTROLIT
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Jumlah cairan tubuh tergantung
Umur
Jenis kelamin
Jumlah lemak tubuh
CAIRAN TUBUH
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LAKI-LAKI PEREMPUAN BAYI
Jumlah Total 60 50 75
• Didalam sl !0 "0 !0
• Di lua# sl
Plasma
I$t#sisial
%0
5
&5
%0
!
&6
"5
5
"0
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BERAT BADAN (60 KG)
GAMBAR SKEMATIS
E'st#a (l ) &% L * %0+ ,
CAIRAN TUBUH TOTAL
36 L = 60%
I$t#sisial Plasma
) L * &5+, )"l * 5+ ,
Na + Cl -
I$t#a (l
) %! L * !0+ ,
K . P/! -
Rongga Ke 3
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KE(EIMBANAN INPUT /UT PUT 1AIRAN 2 %!JAM
) UNTUK BB . 60 K ,
CAIRAN MASUK CAIRAN KELUAR
Minuman : 800 – 1700 ml Urin : 600 – 1600 mlMakanan : 500 – 1000 ml Tinja : 50 – 200 mlHasil ksi!as : 200 – "00 ml #nsensible lss : 850 – 1200 ml
1500 – 3000 ml 1500 – 3000 ml
b h % i
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$ebutuhan %airanMaintanace
• Dewasa :
30-60 !"#BB!$% a&a' 1(5 ml!"#!)am• A*a" :
Berat (kg) ml/kg/jam ml/kg/hr
1 – 10 4 10011 – 20 2 1000cc+(n-10)x50
21 - n 1 2000cc+(n-20)x20
6
• Catatan :Tiap kenaikan t 1oC di atas 37oC tambahcairan 10-15% (12,5%) dari total maintenance replacement
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Tan!a &ehi!rasi
Dehidrasi Gejala
Ringan
Heart rate(10-15% di atas nilai normal
Selapur lendir agak kering
Urin pekat
Produksi air mata
Sedang
!anda di atas tan"ah "erat
!urgor kulit menurun
#liguria
$ata ekung
U"un-u"un ekung
&erat
!anda di atas ''
!ekanan darah
Pengisian kapiler terlam"at (' ) detik*
+sidosis7
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'e!man (ilai )aku *! +nak
!adi
"#$ !$&$
'esp
"#$ !$&$
2-12 bl 10 2 bl 0
1-2 th 120 2-12 bl 50
3-* th 110 1-5 th +0
-* th 30
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$,)UTUH+( %+#-+(-,'.+%,M,(T
/$,)UTUH+( -,H#&-+#ehidrasi easa nak
h rin.an 3% 5%
h sedan. % 10%
h berat 10% 15%
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Da%+ TB,TB, :
-Ba+ : .0/ BB 2alam #%
-A*a" : 40/ BB
-Dewasa : 60/ BB
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-ehi!rasi *a!a +nak
Usia #ralit tiap de,ekasimuntah .ml oralit per hari
) th 50-100 500 hari
)-10 th 100-)00 1000 hari
' 10 th +d li"itum )000 hari
10
/$'#$ '$!!
/$'#$ #/! : pemberian oralit dalam + am pertama
Usia / "l /-11 "l 1)-) "l )-/ th 5-1/ th '15 th
&& 5 5 234 -10 11-15 16-)434 '0
.ml#ralit
)00-/00 /00-600 600-00 00-1)00 1)00-)100 ))00-/000
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-ehi!rasi *a!a +nak
Usia Start 7 R8R+ 0 mlkg
dalam9emudian 7 20 mlkg
dalam
1) "l 1 jam 5 jam' 1) "l 0 menit )35 jam
11
/$'#$ /'T
'ehidrasi pada easa
•4 dalam * am pertama
•4 dalam 1 am keda
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Tetesan %airan *er menit
• Ma"%: a+%a*
)am 3
1 780 &e&es
• M+"%: a+%a*
)am
• T%a*s9's+: a+%a*
)am
1715 &e&es12
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INFUS Na Cl K Ca Asetat Laktat Dekstro-sa
Deks-tran
Protein
RL
NS
Asering
RD5
KAEN1BKAEN3A
KAEN3B
KAENM3
!ts"tran-L
A#i$aren
A#ino%el&''
13'
15(
13'
1()
3*+5&'
5'
5'
13'
,
35
1'
15(
1'
155+5
3*+55'
5'
5'
(
-
3*
(
-
(
(
-1'
,'
,'
3
-
,5
3
-
3
(+5
--
-
-
1'
-
-
-
-
,*
-
--
-
-
-
1,'
35
,*
-
-
-
-,'
,'
,'
,*
-
-
-
-
-
5'
3)+5,)
,)
1''
-
-
-
-
-
-
-
--
-
-
1''
-
-
-
-
-
-
--
-
-
-
1''
5'
13
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ut*ut %airan
• Urine 0,5 – 1 cc/kg/jam
• Tinja, drainase, NGT, muntah
•IWL (Insensibe Water L!ss"10#$0 cc/kb/%& jam
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%nth
•)a3i 6bl4 )) 7 kg4!ehi!rasi berat4 t"8%• Maintenance : 7100700cchari
$reksi /!ehi!rasi berat :159!ari T)159;/809;70008<0
-encana *emberian !alam 6 jam :175=8<01015cc6 jam>
$enaikan t 1 %12459;10151264875>
Ttal kebutuhan !ehi!rasi :1015=12611<1cc6 jam
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T,-+'# %+#-+( '+&+%M)UT#
• A*a" : R'm's Moncrief :
8BBl'as m;'s&+<"e;'& 9aal+ma+*&e*a*e
Ma+*&e*a*e :
0-5 &$ : 100 !K#BB
5-10 &$ : 45 !K#BB
=10 &$ : 50!K#BBKm>s+s+ "%+s&al+2 : "l+27 14:3
,a"&' ?em;e%+a* : @ . )am I @ 16 )amII
16
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Tera*i cairan *a!a %mbusti-umus )a;ter : Untuk &e?asa
<;));9 luas cmbusti
?em;e%+a* :
50/ 50/
. )am I
85/ 85/
. )am II . )am II
17
M+sal BB 750 "# l'as 50M+sal BB 750 "# l'as 50
"e;'&'$a* : 10000!8"e;'&'$a* : 10000!8
)am )am
RL :RL :
. )am I 7 5000 !. )am. )am I 7 5000 !. )am
16 )am16 )am 77
5000!16)am(5000!16)am(
Sela*)'&*a :Sela*)'&*a :
Ke;'&'$a* :8500 ( Km>s+s+ : RL1000
NaCL 500
De&%a* L
500
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• /stimated lood 6olme (/6)
. rematre 100 8 120 cc9k.
. !eonats *0 8 0 cc9k.
. $n;ant ( mr 3 8 12 blan) 75 8 *0 cc9k.
. easa lelaki 70 cc9k.
. easa anita 5 cc9k.
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CARA 8 : TRAUMA STATUS Klas+"as+ 2a%+ S&e*e-G+ese" 11 ACS 13
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?ENDERITA DATANG DGN ?ERDARAHAN
?asa*# +*9's )a%'m ;esa%Am;+l sam>el 2a%a$
Ca&a& :Te" Da%a$( *a2+ ( >e%9's+ ?%2 U%+*e
S+a> 2a%a$ 500 - 1000 ml
R+*#e% La"&a& a&a' NaCL 0 / ! < Kl+2
80 ml ! "# BB e>a&( 'la*#+ sam>a+ 8- ls& l'me 1000 - 8000 ml 2alam 30 - 60 me*+&
Te" Da%a$ = 100 *a2+ F 100>e%9's+ $a*#a&( "e%+*#('%+*e = @ ml ! "# ! )am
'.+ $,-J+
Hem2+*am+" ;a+" Hem2+*am+" ;'%'"
HEMDINAMIK BAIK
B C
HEMDINAMIK BURUK
Te%'s"a* a+%a*8- es&+ma&e2 lss
?e%lam;a& +*9's(&+2a" >e%l' &%a*s9's+
T%a*s9's+ ;l H; F .a&a' H& F 85/
T%a*s9's+ "!>?RC Gl *e#
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$ehilangan &arah
• Ga*&+ >e% ml "e$+la*#a* 2a%a$2e*#a* 3 ml a+%a* "%+s&al+2la%'&a* "%+s&al+2 me%em;es
"el'a% +*&%aas"'le% s>ae
• B+la me*##'*a"a* >%2'"->%2'" 2a%a$ a&a' "l+2 #a*&+
"e$+la*#a* 2e*#a* l'me a*#sama
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$li! @s $ristali!
Cairan <etn.an <er.ian
<oloid 6olme kecil
&ama tin..al diplasma
/dema otak
=ahal
<oa.lopati
/dema par (bila adakebocoran kapiler)
<ristaloid =rah
"rine lebih ban>ak
$#? menin.kat
/;ek hemodinamiktransient
/dema peri;er danpar (dilsi proteindan load)
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,@aluasi $linis 'enggantian%airan
• U%+*e '&>'& : m+*+mal 1ml!"#!)am
• Ta*2a +&al : Te*s+( *a2+ *%mal• ?eme%+"saa* s+" : "'l+& 2a*
m'"sa &+2a" "e%+*#( >as+e*
sa2a% &+2a" me*#el'$ $a's• ?eme%+"saa* la; : >ema*&a'a*
>e%+2+" H; 2a* H&
23
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• +nak laki2 2 thn4 )) 15 kg4 !;: ileus bstruksi*arsial4 T& 110704 ( 1<04 -- "04 T <0 0%
• )agaimana *emberian cairann3a selama 2<
jam4 jenis cairann3a4 jumlah tetesann3aA• $ebutuhan maintenance : 1250 cc2< jam
• -e*lacement : /59;809;15000600cc2<jam
• T : <012459;";/1250=6006B"475
• 1850 = 6B" 2500 cc2<jam
AMI, BMP, HRA, RST 24
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• %ara *emberian :
– %airan kristali!
– Mikr : 25002< 105 t*m
AMI, BMP, HRA, RST 25