Principles of fluid replacement for fasting patients

Humans are meant to eat whole grains. If they fast for a long time, not only will their bodies become weak, but their organs will also have problems. In severe cases, they may even suffer from organ failure. When people are fasting, what the body lacks most is water. The loss of water causes the body to be extremely weak. At this time, you must supplement with glucose. When supplementing, slowly increase the dosage and pay attention to controlling the speed.

There are many cases where internal medicine diseases require infusion treatment, which is often seen in patients who cannot take in food or take in insufficient food orally and have difficulty maintaining physiological needs, such as comatose patients, dehydrated patients, patients with severe esophageal stenosis, and patients who need to quickly replenish effective blood volume, such as those in various shocks, diarrhea dehydration, blood loss, etc. Patients who need fluid infusion to maintain urine output and prevent renal failure. Supplement nutrition and calories and promote the excretion of toxins from the body, etc. Clinical rehydration therapy is required in all these cases. The basic principle for specific fluid replenishment is generally: it varies from person to person and from disease to disease, replenish what is lacking and take in according to the amount of fluid replenishment.

1. Sugar, generally glucose, 250-300g (5% glucose injection specifications 100ml: 5g, 250ml: 12.5g, 500ml: 25g

10% glucose injection specifications 100ml: 10g, 250ml: 25g, 500ml: 50g)

2. Salt, generally sodium chloride, 4-5g (0.9% sodium chloride injection: take 0.9 grams of sodium chloride, dissolve in a small amount of distilled water, and dilute to 100 ml. 0.9% sodium chloride injection specifications 100ml: 0.9g, 250ml: 2.25g, 500ml: 4.5g)

3. Potassium, generally refers to potassium chloride, 3-4g (10% potassium chloride solution, specification: 10ml:1g. Generally, 10% potassium chloride injection 10-15ml is added to 500ml of glucose injection)

4. Generally, there is no need to supplement protein or fat during the 3-day fasting period. More than 3 days, supplement every day

Protein, fat.

5. Order of fluid replacement: A. First use isotonic saline or balanced salt solution to expand blood volume and increase urine output to restore the body's regulatory ability. B: If there are signs of acidosis after the increase in urine output, alkaline solution can be supplemented by increasing CO2cp by 10v% each time, and pay attention to potassium and calcium supplementation. C. When blood volume is insufficient after volume expansion, a certain amount of colloidal fluid (whole blood, plasma, dextran) needs to be supplemented. D. When the amount of fluid replacement is large, various types of fluids should be input alternately.

6. Fluid replacement speed: a. For patients with severe conditions, start quickly and replenish 1/2 of the daily fluid intake in the first 8 hours. When the condition improves, the speed should be slowed down. b. For patients with poor cardiopulmonary function or certain drugs that cannot be infused quickly (such as hypertonic saline and potassium salt), the speed should be controlled.