Wednesday, June 3, 2015

The second preload option is to use colloidal liquid as colloid infusion capable of filling how to


Spinal anesthesia also called a subarachnoid block anesthesia techniques are quite popular, namely by inserting local anesthetic into the lumbar subarachnoid space to produce or cause the loss of activity of sensory and motor function blocks how to make methamphetamine (RA Stevens, 1996).
Spinal anesthesia is growing and expanding its use, considering the various how to make methamphetamine advantages offered them relatively cheaper price, small systemic effect, analgesia which adekwat and the ability to prevent the stress response is more perfect, (Marwoto et al, 1992).
Hypotension is one of the complications of acute spinal anesthesia is most often the case, (RR Gaiser, 1997: 216). Prospective study conducted on more than 1800 patients who received spinal anesthesia, 26% had complications, such as hypotension majority (16%), (Collin VJ, 1993). Carpenter et al study which found the incidence of hypotension gain of 33% (Carpenter how to make methamphetamine RL, 1992) and in the case of sectio caesarea hipotennsi incidence reached 80% (Bisri T, 1997).
Hypotension typically occurs in 15 to 20 minutes after the first injection of subarachnoid (Conception M, 1996), if not carried out preventive hypotension due to spinal anesthesia will cause symptoms associated with hipoksi network in the form of anxiety, dizziness, nausea, later if not addressed can lead to More severe effects are shock and even death (Colin VJ, 1993).
Hypotension after spinal anesthesia is pharmacological denervation caused by preganglionic sympathetic nerve which can cause vasodilation and reduction in systemic vascular resistance. There are three main mechanisms of hypotension after spinal anesthesia: Decrease backflow, venous vasodilation, and decreased cardiac output. Precautions and overcome hypotension due to spinal anesthesia is the use of intravenous fluids and vasopressor drugs (Rushman GB, 1999).
The purpose how to make methamphetamine of infusion fluid is to fill out and meet the vascular space, increasing the circulation volume and cardiac output so as to compensate for the reduction in systemic vascular resistance. Administration of crystalloid preload 10-15 ml / kg body weight is recommended as a way to prevent hypotension after spinal anesthesia (GE Morgan, 1992).
Various studies have reported that the preload of crystalloid alone failed to prevent the incidence of hypotension due to spinal anesthesia (GE Park, 1996). Jackson et al reported preload of crystalloid fluids failed how to make methamphetamine to prevent how to make methamphetamine the incidence of hypotension due to spinal anesthesia in sectio caesarea either get crystalloid 200 ml or 1000 ml who received crystalloid (Jackson R, 1995).
The second preload option is to use colloidal liquid as colloid infusion capable of filling how to make methamphetamine the vascular space longer and more effectively. how to make methamphetamine Several studies using colloidal among others Buggy et al reported 500 ml Hemaccel not reduce the incidence of hypotension and vasopressor requirement compared with crystalloid preload and without a preload (Buggy D, 1997). Sharma et al, reported that preload with 500 mL of colloid (Haes 6%) is more effective than in 1000 ml crystalloid (Ringer lactate) to prevent hypotension in spinal anesthesia on tubal ligation in women post partum, how to make methamphetamine but not all patients free of hypotension (SK Sharma , 1997)
Sectio caesarea is surgery to give birth to the fetus by opening the abdominal wall and the wall of the uterus or vagina or a hysterotomy how to make methamphetamine for delivery of a fetus from the uterus (Prawiroharjo, 2001).
Sectio caesarea is one indication of spinal anesthesia. The central surgical installation data (IBS) Hospital Woodward Palu, from year to year is always an increase in the use of regional anesthesia techniques. From the data obtained in Palu Woodward Hospital in 2007 was about 40% using the technique of regional anesthesia and regional anesthesia techniques among techniques how to make methamphetamine largest how to make methamphetamine spinal anesthesia, the year 2008 recorded a mother who had surgery sectio caesarea as many as 112 people, in 2009 as many as 121 people and in 2010 the month of January to May of 60 people, about 85% of spinal anesthesia. A condition that occurs when it is found sectio caesarea patients with spinal anesthesia hypotension, especially in 1 to 20 minutes first, and as a result of hypotension causes patients to feel uncomfortable, namely nausea, dizziness and headaches, because preload is provided only kritaloid 15 ml / kg (RS Woodward Palu, 2009).
Given these conditions as nurses need to provide comfort for patients is to maintain stable blood pressure during how to make methamphetamine spinal anesthesia. It is therefore important to know the effectiveness of intravenous fluids appropriate for the patient sectio caesarea during spinal anesthesia, the researchers are interested how to make methamphetamine in making research on: the effectiveness of intravenous fluids colloids than crystalloid for p

Tuesday, June 2, 2015

Kinds or types of intravenous office cleaning fluids and their role: 1. hypotonic fluid. Fluid admi


Kinds or types of intravenous office cleaning fluids and their role: 1. hypotonic fluid. Fluid administered is lower than serum osmolarity (Na + ion concentration lower than serum), so late in the serum, and lower serum osmolarity. Then fluid "pulled" out of the blood vessels into surrounding tissues (the principle of fluid move from low to high osmolarity osmolarity), until eventually fill the target cells. Used in cell state "experience" dehydration, for example in dialysis patients (dialysis) in diuretic therapy, also in patients with hyperglycemia (high blood sugar levels) with diabetic ketoacidosis. Threatening complication is sudden displacement of fluid from the blood vessels into cells, causing cardiovascular collapse and increased intracranial pressure (in the brain) in some people. An example is the 45% NaCl and 2.5% Dextrose. 2. Isotonic liquid. Is fluid administered office cleaning osmolarity (density) of fluid approach serum (the liquid part of blood components), thus persist in the blood vessels. Helpful in patients with hipovolemi (lack of body fluids, so the blood pressure continues office cleaning to decline). Have a risk of overload (excess fluid), particularly in disease congestive heart failure and hypertension. Examples are liquid-Ringer Lactate (RL), and normal saline / saline (0.9% NaCl). 3. hypertonic fluid. Intravenous fluid osmolarity is higher than the serum, so the "pull" of fluid and electrolytes from the cells into the tissue and blood vessels. Able to stabilize blood pressure, increases the production of urine, and reduce edema (swelling). Its use is contradictory with hypotonic fluid. For example Dextrose 5%, 45% hypertonic office cleaning saline, Dextrose 5% + Ringer-Lactate, Dextrose 5% NaCl + 0.9%, blood products (blood), and albumin. Another liquid division is based on the group: 1. Crystalloids: is isotonic, it is effective in filling a liquid volume (volume expanders) into the blood vessels office cleaning in a short time, and is useful in patients who require immediate fluid. For example Ringer-Lactate and physiological saline. 2. Colloid: their molecular office cleaning size (usually a protein) is large enough so it will not come out of the capillary membrane, and remain in the blood vessels, then its hypertonic, and can draw fluid from outside the blood vessel. Examples are albumin office cleaning and steroids. Fluids used in fluid therapy is often used is a liquid electrolyte (crystalloid) non-electrolyte office cleaning liquid, and colloidal liquids. Electrolyte fluid (crystalloid): In accordance with its use can be divided into several groups, namely for maintenance, replacement and specific objectives. Fluid maintenance (maintenance): The aim is to replace body water loss through urine, feces, lungs and sweat. Total body water loss is different according to age, namely: Adult: 1.5 to 2 ml / kg / hour Children: 2-4 ml / kg / hr Babies: 4-6 ml / kg / hr Orok (neonates) : 3 ml / kg / h Given the fluid lost in this way very few contain electrolytes, then as a replacement fluid is hypotonic, with particular attention to sodium. Crystalloid solution for maintenance eg 5% dextrose in 0.45% NaCl (D5NaCl office cleaning 0.45). Liquid dosage Maintenance (maintenance) office cleaning Fluid replacement: The goal is to replace body water loss caused by sequestration or other pathological processes (eg fistula, pleural effusion, ascites gastric drainage etc.). As a replacement fluid used for this purpose isotonic fluid, with special attention to the concentration of sodium, for example, 5% dextrose in Ringer's lactate (D5RL), 0.9% NaCl, NaCl D5. Substitute Liquid Liquid office cleaning preparations for special office cleaning purposes (correction): The definition is specifically used crystalloid fluid, for example sodium bicarbonate 7.5%, 3% NaCl, etc. Correction Fluid Liquid preparations non electrolytes: Example dextrose 5%, 10%, is used to meet the needs of water and calories, can also be used as maintenance fluid. Colloids: Also referred to as plasma expanders, because office cleaning it has a great ability in maintaining intra-vascular volume. Examples of these fluids include: Dextran, Haemacel, Albumin, Plasma, Blood. The colloid fluids are used to replace lost fluids intra-vascular.
Veranda


Monday, June 1, 2015

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Herdiantri Sufriyana Blogging For Life Main menu Skip to content Menu Home Traffic Statistics Bibliography About the Author Contact the Author Health Allergy Blood Pressure Herbal Diabetes Digestive Vitality Sari Mulia Obstetric Medicine Medicine Orthopedics Entrepreneurship Medicolegal Umroh
Crystalloid fluid resuscitation should be considered as early in patients with hemorrhagic and septic shock, in burn patients, in patients with head injury to maintain cerebral perfusion pressure, and in patients undergoing liver resection or plasmapheresis. If 3-4 L of crystalloid has been granted and the hemodynamic response is inadequate, it can be added to a liquid colloid. [2]
Intravenous fluids selected according to the type of fluid loss is replaced. To lose body fluids, especially those involving water course, replacement is the infusion of hypotonic fluids, also called intravenous tyresö fluids types of maintenance (maintenance-type solution). If the loss of body fluids involving water and electrolytes, intravenous fluid replacement is with isotonic electrolyte, also called intravenous fluid replacement types (replacement-type solution). Glucose is provided on several intravenous fluids to maintain tonicity or to prevent ketosis or hypoglycemia because of fasting. Children are vulnerable to experiencing hypoglycemia (<50 mg / dL) with only 4-8 hours of fasting. Women are also much easier to experience fasting hypoglycemia with long (> 24 hours) tyresö than men. [2]
Since most missing intraoperative fluid is isotonic, it is commonly used intravenous fluid replacement types. The most commonly used fluid is a liquid tyresö Ringer lactate. Although slightly hypotonic, intravenous fluids provide approximately 100 ml per liter of free water and tend to lower serum sodium to 130 mEq / L, Ringer lactate generally have the least effect on the composition of extracellular fluid and seems to be the most physiological infusion fluid when needed granting tyresö large volume , Fluid lactate is converted by the liver into bicarbonate. When given in large volumes, normal saline hyperchloraemic dilutional acidosis due to sodium and chloride content is high (154 mEq / L) where the plasma bicarbonate concentration decreases tyresö with increasing concentration of chloride. Normal saline is the preferred intravenous fluids for metabolic alkalosis tyresö hypochloraemic and to dissolve packed red blood cells prior to transfusion. tyresö Five percent dextrose in water (D5W) is used for the replacement of pure water deficits and as maintenance fluids to patients with sodium restriction. Saline (salt) 3% hypertonic used in the treatment of severe symptomatic hyponatremia. Saline 3% to 7.5% is recommended for patients with hypovolemic shock resuscitation. This intravenous fluids should be administered slowly (preferably through a central venous catheter) as easily lead to hemolysis. [2]
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