1. MonashC ritical Care hildrens
2. Colloid of the YearvsOverused & Overated
3. Posm
4. Plasma InterstitialH22O
H2ONa+Na+Na+Na+Na+Na+K+Na+Na+ATPExtracellular Fluid Intracellular
Fluid
5. Plasma
InterstitialAlbNa+AlbNa+Na+Na+Na+Na+Na+AlbAlbAlbExtracellular Fluid
Intracellular Fluid
6. Plasma InterstitialExtracellular Fluid Intracellular
Fluid
7. Plasma InterstitialExtracellular Fluid Intracellular
Fluid
8. AAAAAAAPlasma InterstitialExtracellular Fluid Intracellular
Fluid
9. Plasma InterstitialAAAAAAAExtracellular Fluid Intracellular
Fluid
10. Plasma InterstitialAAAAAAAExtracellular Fluid Intracellular
Fluid
11. Plasma InterstitialAAAAAAAExtracellular Fluid Intracellular
Fluid
12. Na+Na+Na+Na+Na+Na+Na+Plasma InterstitialExtracellular Fluid
Intracellular Fluid
13. Plasma InterstitialNa+Na+Na+Na+Na+Na+Na+Extracellular Fluid
Intracellular Fluid
14. Plasma InterstitialNa+Na+Na+Na+Na+Na+Na+Extracellular Fluid
Intracellular Fluid
15. F = Kf [( Pvasc Pi ) ( vasc i )]
16. F = Kf [( Pvasc Pi ) ( vasc i )]
17. F = Kf [( Pvasc Pi ) ( vasc i )]
18. F = ( vasc i )
19. Posm
20. 280mmol/L 3% Saline
21. 280mmol/L 3% Saline Osm = 1027-280 = 747mosmol/L = 747
19.32mmHg
22. 280mmol/L 3% Saline Osm = 1027-280 = 747mosmol/L = 747
19.32mmHg
23. N. SalineN. Saline Osm = 40 67,000 = 0.6mosmol/L = 0.6
19.32mmHg+40gm/l Albumin
24. N. SalineN. Saline+40gm/l Albumin
25. N. Saline N. Saline+40gm/l Albumin+8gm/l Albumin = 8/67,000
X 19.32= 2.3 mmHg
26. N. Saline N. Saline+40gm/l Albumin+8gm/l Albumin2.3
mmHg
27. 2.3 mmHg 11 mmHgN. Saline N. Saline+40gm/l Albumin+8gm/l
Albumin
28. 2.3 mmHg 11 mmHgN. Saline N. Saline+40gm/l Albumin+8gm/l
Albumin
29. 2.3 mmHg 11 mmHgN. Saline N. Saline+40gm/l Albumin+8gm/l
Albumin = 0.8
30. 2.3 mmHg 11 mmHgN. Saline N. Saline+40gm/l Albumin+8gm/l
Albumin0.8 (11 -2.3)(vasc - i)
31. 2.3 mmHg 4.3 mmHgN. Saline N. Saline+15gm/l Albumin+8gm/l
Albumin0.8 (4.3 -2.3)(vasc - i)
32. 2.3 mmHg 4.3 mmHgN. Saline N. Saline+15gm/l Albumin+8gm/l
Albumin0.8 (4.3 -2.3)(vasc - i)
33. 2.3 mmHg 4.3mmHg to 5.8mmHgN. Saline N. Saline+15gm/l to
20gm/lAlbumin+8gm/l Albumin0.8 (5.8 -2.3)(vasc - i)
34. 2.3 mmHg 4.3mmHg to 5.8mmHgN. Saline N. Saline+15gm/l to
20gm/lAlbumin+8gm/l Albumin=1.2mmHg
35. 18mmHg90mmHg10mmHg2mmHg6mmHg
36. F = Kf [( Pvasc Pi ) ( vasc i )]
37. 35 yo woman on IVF Admitted with OHSS Rx with 5% Albumin
Increasing breathlessness ?PE Transported to ICU
38. Breathless, sitting uprightHR 120, BP 130/70, CVP 7 Pitting
oedema to mid sterumSerum Albumin 30gm/L
39. ICU O&GDo Nothing!Diurese More5% Albumin
40. Diuresis
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
Oedema & breathlessness resolved To ward
41. Diuresis
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
Oedema & breathlessness resolved To ward
42. Diuresis
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
Oedema & breathlessness resolved To ward
43. Volume Overload140117937047230Pressure
mmHgArteriolesCapillariesVenules& VeinsArteries
44. F = Kf [( Pvasc Pi ) ( vasc i )]
45. Plasma InterstitialExtracellular Fluid Intracellular
Fluid
46. Plasma InterstitialExtracellular Fluid Intracellular
Fluid
47. Plasma InterstitialExtracellular Fluid Intracellular
Fluid
48. Na+Na+Na+Na+Na+Na+Na+Plasma InterstitialExtracellular Fluid
Intracellular Fluid
49. Na+Na+Na+Na+Na+Na+Na+Plasma InterstitialExtracellular Fluid
Intracellular Fluid
50. Plasma InterstitialNa+Na+Na+Na+Na+Na+Na+Extracellular Fluid
Intracellular Fluid
51. Plasma InterstitialNa+Na+Na+Na+Na+Na+Na+Extracellular Fluid
Intracellular Fluid
52. Plasma InterstitialNa+Na+Na+Na+Na+Na+Na+PiPiExtracellular
Fluid Intracellular Fluid
53. Na+Na+Na+Plasma
InterstitialNa+Na+Na+Na+Na+Na+Na+Extracellular Fluid Intracellular
Fluid
54. Plasma
InterstitialNa+Na+Na+Na+Na+Na+Na+Na+Na+Na+Extracellular Fluid
Intracellular Fluid
55. Plasma
InterstitialNa+Na+Na+PiNa+Na+Na+Na+Na+Na+Na+Extracellular Fluid
Intracellular Fluid
56. PlasmaNa+Na+Na+Na+Na+Na+Na+Na+Na+Na+Extracellular Fluid
Intracellular Fluid
57.
Na+Na+Na+Na+PlasmaNa+Na+Na+Na+Na+Na+Na+Na+Na+Na+Extracellular Fluid
Intracellular Fluid
58.
PlasmaNa+Na+Na+Na+Na+Na+Na+Na+Na+Na+Na+Na+Na+Na+Extracellular Fluid
Intracellular Fluid
59.
PlasmaNa+Na+Na+Na+Na+Na+Na+Na+Na+Na+Na+Na+Na+Na+Extracellular Fluid
Intracellular Fluid
60. SomethingSomething elseO.R.1.3(0.5,
2.6)2.1(1.0,3.4)1.8(0.9,3.3)2.3(1.9,2.7)2.1(1.8,2.5)2.2(1.9,
2.4)1.0 2.0 3.0ORSmith et al 1991Jones et al 1993Smith et al 1999Ng
eta 2004Chu et al 2009
61. The only colloidproven to be notworse than saline!
62. SAFE Study:Albumin vs Saline: Volume
administered3000200010000Albumin SalineDay 1 Day 2 Day 3 Day 41.3
1.6 1.3 1.21.4 1.6 1.3 1.4Mean RatioMean + SD
LOAD MORE