Two issues here - 1. maintaining volume within cardiovascular
system -which includes adipose tissue
2. flushing of
metabolically active tissue.
So which volume measure is more important/ more dangerous if neglected?
Dale Brochis BA
Gainsharing Project Coordinator
Case Management Department
Robert Wood Johnson University Hospital at Rahway
865 Stone Street
Rahway, NJ 07065
732-499-6217 Office / 732-428-2108 Cell
[email protected] <mailto:[email protected]>
From: Sepsisgroups [mailto:[email protected]]
On Behalf Of Barnes-Daly, Mary Ann
Sent: Thursday, May 29, 2014 6:19 PM
To: 'Kelsey K. Solano'; '[email protected]'
Subject: Re: [Sepsis Groups] Fluid Bolus in pts. with weight > 200 kg
Every recommendation that I have seen or heard, most recently from the
faculty on the SSC, is to go with actual body weight.
Remembering that adipose tissue is highly vascular and contains a large
amount of water and that the main 2 reasons for the fluid bolus are 1.
Vasodilation reducing perfusion pressure and more importantly 2.
Capillary leaking - and with all those miles (literally) of leaky
capillaries obese patients have a very high propensity for intravascular
volume depletion.
From: Sepsisgroups [mailto:[email protected]]
On Behalf Of Kelsey K. Solano
Sent: Wednesday, May 28, 2014 7:05 AM
To: [email protected]
Subject: [Sepsis Groups] Fluid Bolus in pts. with weight > 200 kg
I am wondering whether there are any recommendations regarding fluid
resuscitation in patients weighing >200 Kg? Our physicians have
expressed concern about the recommended fluid bolus for patients who are
> 200 Kg and potential for CHF exacerbations. Are there any resources
that address this concern or any modifications for this patient
population? Also, is it always recommended to go with 30 ml/kg based on
current weight or should we be calculating ideal weight when determining
bolus volume? Currently we are using the patient's actual weight on
admission for bolus calculations. Any clarifications regarding the
fluid bolus would be greatly appreciated.
Thanks,
Kelsey K. Solano
Sepsis Coordinator
Email: [email protected]
Office: 574-335-2438
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