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Fluid (colloid (25% (renal injury, death in circulatory shock), Dextrans…
Fluid
colloid
expand plasma volume
5% safety
25%
renal injury
death in circulatory shock
Starch
Dextrans
dose-related bleeding tendency
D5W
提供energy
50×3.4=170kCal/L
3L=>510kCal/day
足夠nonprotein calories
cellular swelling
lactate 上升
高血糖
crystalloid fluid
25% plasma
75%間質液
N/S
volume effect
:!:figure 12.2
interstital edema
大量造成代謝酸
R/L
好處:不會代謝酸
不好:有Ca2+,不用於輸血
除非大量給予，否則lactate很難高
比較
crystalloid 便宜
而且survial rate 差不多
結論
case by case
colloid 佳