Fluid and Electrolyte in

Surgery
Blood Transfusion in Surgery
Blood Transfusion in Surgery
INTRODUCTION
DIFFERENT BLOOD GROUPS
WHEN DO YOU TRANSFUSE BLOOD IN SURGERY
TYPES OF TRANSFUSION
COMPLICATIONS OF BLOOD TRANSFUSION
TREATMENT OF COMPLCATIONS
CONCLUSION
Introduction
• Definition
• Components
• Some concepts about transfusion
Different blood groups
• A
• B
• AB
• O
• Rhesus positive
• Rhesus Negative
When do you transfuse blood in surgery
• Allowable blood loss
Types of transfusion
• Whole blood
• Red cell
• Plasma
• Platelet
• Homologous/allogenic
• Autologous
• Exchange
Complications of blood transfusion
• Immediate
• Delayed
• Transfusion reaction [ incompatibility/allergic reaction]
• Chills
• Rigors
• Skin flushing
• Itching
• Back/flank pain
• Dark urine
Complications contd
• Shortness of breath
• Acute kidney failure
• Anaemia
• Shock
• Death
• TRALI [6hrs]
• TACO
• TAD [24HRS]
• TTI [Malaria etc]
• Iron overload
Treatment
• Xcheck blood
• Stop blood
• Take another sample
• Regp& xmatch
• IV Normal saline
• others
Conclusion
• Blood transfusion has serious complications; attention should be paid
to details and should only be carried out when it is indicated.
Fluid and electrolyte in Surgery
• Introduction
• Anatomy of body fluids compartments
• Common Fluids used in surgery
• Electrolytes
• Fluid management in surgery
• Correction of electrolyte deficit
• Conclusion
Introduction
• Enzyme systems and metabolic processes responsible for the
maintenance of cellular function are dependent on an environment of
stable fluid and electrolyte
• Fluid and electrolyte management is paramount to the care of surgical
patients preop,intraop and postop
Anatomy of body fluids compartments
• Total body water constitute about 60% of totl body weight as
measured using deuterium oxide in indication dilution method.
• 60% for male
• 50% for female
• 80% for newborn
• 65% at infancy
Anatomy of body fluids
• Volume of total body water is 40L
• 25L - ICF
• 15L- ECF[ plasma plus interstitial fluid]
Electrolytes
• Potassium – 3.5-5.5 mmol/l
• Sodium – 133-148mmol/l
• Chloride – 95-105mmol/l
• Bicarbonate - 22-30mmol/l
• Phosphate – 0.8-1.4 mmol/l
Common fluids used in surgery
• Normal saline
• Ringers lactate
• Dextrose saline
Fluid management in surgery
• Deficit
• Maintenance
• 100mls/kg/day ie 4mls/kg/hr
• 50mls/kg/day ie 2mls/kg/hr
• 20mls/kg/day ie 1ml/kg/hr
• 4,2,1
Correction of electrolyte deficit
conclusion
• Fluid and electrolyte balance must be ensured preop, intraop and
postop to avoid complications that may lead to death of patients.
• Thank you for listening