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BODY FLUIDS BALANCEAtan Baas Sinuhaji Department of
ChildHealthSchool of Medicine,University Of Sumatera Utara
Medan
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FLUIDS AND ELECTROLYTES BALANCE
BODY FLUIDS BALANCE (PEDIATRICS)
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BODY FLUIDSSOLVENTSDISSOLVED SUBSTANCES:WATERELECTROLYTESGLUCOSE
PROTEINFATGASES (O2, CO2)
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BODY FLUIDSBARRIER/PROTECTIVE
CUSHIONTRANSPORTCSFLUBRICANTSYNOVIAL
FLUIDSSOLVENTSREACTANTHYDROLYSISTEMPERATUREDEHYDRATION FEVER
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1. VOLUME2. DISTRIBUTION3. COMPOSITION OF ELECTROLYTES4.
TONICITY5. pHREGULATIONEQUILIBRIUM
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TBW(60-70%)ICF : 40 - 45%ECF : 20 -
25%ISF15%PLASMA5%Trancelluler1-3%
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THE DIFFERENCES BETWEEN PEDIATRICS AND ADULT BODY FLUIDS 1.TBW
PEDIATRICS >ADULT(60 - 70%)(50 - 55%)2. ECF : ICFNEONATES = 1 :
1CHILDHOOD = 2 : 3ADULT = 1 : 23. DAILY TURNOVER OF WATERINFANT =
25% TBWADULT = 6% TBW
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INFANTS ARE SUSCEPTIBLE TO THESE DISORDERS 1. DAILY TURNOVER OF
WATER >>2. INFANT IS MORE SUSCEPTIBLE THAN ADULT DIARRHOEA,
VOMITING3. HOMEOSTASIS MAY NOT BE AS WELL DEVELOPED
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INFANT 7 kgECF = 1400 mLINTAKE= 700 mL/dayOUTGO= 700 mL/day
ADULT 70 kgECF= 14 LINTAKE= 2 L /dayOUTGO = 2 L/day
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VOLUME Renal Blood Flow RENIN ALDOSTERON H2O & Na+
RETENTION
VOLUME VOLUMERECEPTORSTHIRST CENTREADH (Antidiuretic
Hormone)WATER INTAKE WATER RETENTION
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TONICITY DILUTION OF ECFTHIRST CENTEROSMORECEPTORSADH WATER
INTAKETONICITY
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OSMOTIC PRESSURE(290 mOsm/L)Na+ = 135 mEQ/LBUN (Blood Urea
Nitrogen)GLUCOSE
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INTAKETHIRST CENTREOSM 30 mL / kgBW /
dayVOLOUTPUTABSORPTIONSTOOLKIDNEYSSKIN & LUNGS10 mL / kgBW /
day60 mL / kgBW / dayREGULATION ALDOSTERON ADH
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HOLLIDAY - SEGAR 10 kg100 mL / kg 10 - 20 kg1000 mL + 50 mL/ kg
for each > 10 kg > 20 kg1500 mL + 20 mL/ kg for each > 20
kg NB : 100 mL 2,5 mEq Na+ 2 mEq K+ 100 calori
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OSMOLALITY VOLUME ADH REABSORPTION OF WATER IN THE DISTAL
TUBULES & COLLECTING DUCTS
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OSMOLALITY VOLUME ADH VOLUME IS THE 1ST
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DISTRIBUTION OF WATERI VFCAPILLARY WALLSISFSTARLING
FORCESICFTONICITYCELL WALLSNa+ECF
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STARLING FORCES: BALANCE OF HYDROSTATIC PRESSURE & ONCOTIC
PRESSUREONCOTIC PRESSUREPLASMA PROTEINALBUMIN
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S LAW OF THE HEART RELATION OF TENSION TO LENGTH IN CARDIAC
MUSCLE FORCES DISTRIBUTION OF WATER BETWEEN INTERSTISIAL &
INTRAVASKULAR
STARLING
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COMPOSITION OF ELECTROLYTESECFICFNa+>
