Basic Concepts of Fluid and Electrolyte Therapy
Basic Concepts of Fluid and Electrolyte Therapy
Basic Concepts of Fluid and Electrolyte Therapy
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Management<br />
Prevention<br />
Any patient admitted to hospital who is acutely ill or undergoing<br />
major surgery who has been identified as at risk <strong>of</strong> developing AKI<br />
(Table 18) should<br />
have a daily clinical volume status assessment<br />
have a daily assessment <strong>of</strong> the fluid prescription<br />
have a daily fluid balance chart<br />
have daily weights<br />
avoid nephrotoxic agents [e.g. non-steroidal anti-inflammatory<br />
drugs (NSAIDs), aminoglycosides]<br />
have other drugs (e.g. antihypertensive medications such as angio -<br />
tensin converting enzyme inhibitors, angiotensin receptor blockers)<br />
reviewed especially if they develop hypotension <strong>and</strong>/or sepsis<br />
have urea, creatinine <strong>and</strong> electrolytes checked daily until they<br />
regain health<br />
Any acutely ill patient with AKI or at high risk for AKI (Table 18)<br />
undergoing an iodinated contrast study should<br />
be discussed with the radiologists with respect to the risk factors<br />
<strong>and</strong> alternative imaging<br />
have nephrotoxic medication stopped<br />
have a daily clinical volume status assessment<br />
have a daily fluid balance chart<br />
have daily weights<br />
receive intravenous fluid at 1 ml/kg/hour 12 hours prior to <strong>and</strong> 12 hours<br />
following the procedure (caution if cardiac failure) selecting either<br />
0.9% saline or<br />
isotonic (1.4%) sodium bicarbonate solution<br />
have urea, creatinine <strong>and</strong> electrolytes monitored for 3-5 days<br />
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