Fluid Resuscitation

Course overview

Objectives Explain the concept of permissive hypotension Discuss research regarding fluid resuscitation Describe Mean Arterial Pressure MAP as a tool to evaluate perfusion better Content I Fluid Therapy a Permissive hypotension allowing specific patients to experience some degree of hypotension in certain settings i The goal of fluid resuscitation is to maintain vital organ perfusion ii Level of consciousness is an indicator of vital organ perfusion iii Assessment of the level of consciousness may guide the need for fluid administration iv Normalization of blood pressure through fluid administration may be harmful and is discouraged II Dangers of excessive crystalloid administration a Dilution of clotting factors and platelets b Physical disruption of a clot c Expanding the area of vascular defect as blood pressure increases d Enhances red blood cell loss thus reducing the total oxygen carrying capacity of the blood e Research III Understand Mean Arterial Pressure MAP as a tool to better evaluate perfusion a Mean Arterial Pressure MAP is a better assessment tool to determine perfusion to vital organs compared to systolic blood pressure b Calculated using the following formula i MAP Diastolic Pressure 1 3 Pulse Pressure c Example If your patient has a BP of 120 80 then to calculate their MAP MAP 80 120 80 3 MAP 80 40 3 MAP 80 13 3 MAP 93 3 or about 93 d Aim for a MAP of 60 65 mmHG during fluid therapy IV Discuss and understand local fluid resuscitation protocol