PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith...

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Transcript of PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith...

Page 1: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 2: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 3: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
http://upload.wikimedia.org/wikipedia/commons/c/cc/John_Snow.jpg
Page 4: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination

Southwark Lambeth

120 0 60

Page 5: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
http://en.wikipedia.org/wiki/File:Chol_an.gif
Page 6: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 7: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 8: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 9: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 10: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination

Na+ 134 mmol/l Cl- 118 mmol/l HCO3

- 16 mmol/l

Page 11: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 12: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 13: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 14: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination

Na+ 130 mmol/l K+ 4 mmol/l Ca++ 1,15 mmol/l Cl- 109 mmol/l HCO3

- 28 mmol/l

Page 15: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 16: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 17: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 18: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination

Colloïden

Page 19: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination

Colloïden, hoe werken ze?

1 Exluded volume

2 Gibbs Donnan

Zeta potentiaal

Page 20: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination

[Na+]1 [Cl−]2

[Na+]2 [Cl−]1

=

http://www.ijponline.net/content/35/1/36/figure/F3
Page 21: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 22: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 23: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination

Albumine

Page 24: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 25: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination

Hydroxy-ethylzetmeel 6%

HES

Page 26: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination

Leuconostoc mesenteroides

Dextranen

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//upload.wikimedia.org/wikipedia/commons/f/f9/Dextran_ball-and-stick.png
Page 27: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination

Gelatine

H2O

//commons.wikimedia.org/wiki/File:Collagentriplehelix.png
Page 28: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 29: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination

Voordeel van colloïden

Page 30: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination

Problemen met colloïden

Albumine Duur

Gelatine

Dextranen Anafylaxie, von Willebrand

HES

Anafylaxie, nierinsufficiëntie

Page 31: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 32: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 33: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 34: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 35: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination

De data

Page 36: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 37: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination

Sterfte

Albumine

HES

Gelatine

Dextranen

Page 38: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination

HES

Page 39: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 40: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 41: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 42: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 43: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 44: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 45: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 46: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 47: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 48: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 49: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 50: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination

pH 7,28

BE -4 mmol/l

pH 7,28

BE -5 mmol/l

Page 51: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination

Chloride en acidemie

Page 52: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 53: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination

Na+

Cl-

HCO3-

H+

H2CO3

Page 54: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination

Na+ O H

H

+

+ -

H

+

Page 55: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 56: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination

Chloride en acidemie

Page 57: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 58: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination

Water of NaCl 0,9% Ringer

Page 59: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 60: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 61: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination

Doet het ertoe?

Page 62: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 63: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 64: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination
Page 65: PowerPoint-presentatie · 2018. 12. 20. · of my able and respectable colleagues of the Leith Cholera Hospital, as to the imme- diate cause of death in this case, before an examination

Tja…

Er is niet veel ‘fysiologisch’aan 0,9% NaCl

Maar wel veel ervaring

Ringer wint het op anciënniteit

Maar ... er is geen bewijs


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