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<136 mEq/L
1. 2. 3. 4.
1. 2. 3. 4.
100mg/dl 100mg/dl
1. 2. 3. 4.
1. 2. 3. 4.
( ( )
) , ( ( ) )
1. 2. 3. 4.
DH
1
=2 +( /18)+ / 6)
. 298 mOsm/kg
1 2
0.5mEq/ 0.5mEq/
>200 mOsm/kg
<200 mOsm/kg
>145 mmol/L
90% .
ICF . a++-ATPase
3
+.
a+
ECF.
y [
+]
. [
+]
. +)
+.
y
+
H
+
( [
+]
(
+)
2: ; (EKG) .
3:
+;
1) ), 3) ) 4) .
, 2) ( -
( , , 5) ,
2.
+
.
+
. Na+. + +
+ +(
+-
Pase, ).
+ 1) 2) ( ( ( ), 4) , , 5) ( ). . ( ), ), 3) ,
HCO3 + +. +
(
).
Na+,
+-
Na+/H+ ( ). Na+-
Pase
2-
+ Na+ - + -
Pase
4:
+;
[ +]
V
y + [ ] ClCl-
[ +] > 7 mmol/L /
EKG .
Fluid
Osmolality (mOsm/l)
Distribution space
:
: :
: albumin(5%, albumin(5%, 25%) gelatin solutions (Plasmagel,Haemacell,Gellifundol) : starches (6% hetastarch, 10% pentastarch) dextrans (dextran-40 in normal saline, dextran-70 in dextrandextran5% dextrose in water)
Colloids vs Crystaloids
Supra -resuscitation
45 40 35 30 25 20 15 10 5 0 IAH ACS MODS MOR Supra Norna