- Amino acids provide protein, calories, and fluid for the body. It is helpful
for patients who are old and malnourished and for those with hypopro-
teinemia resulting from other causes. - Hetastarch is a non-antigenic used to treat or prevent shock following seri-
ous injury, surgery, or for burn patients when blood is not available for
transfusion. This too isn’t a substitute for whole blood. In an isotonic solu-
tion (310 mOsm/L), hetastarch decreases platelet and hematocrit counts
and must not be used for patients who have bleeding disorders, congestive
heart failure (CHF), and renal dysfunction. - Plasmanate is a protein-containing fluid that is derived from human plasma
and is used to treat shock that results from burns, crushing injuries, abdomi-
nal emergencies, or any emergency where there is a loss of plasma, but not
red blood cells. Plasmanate is non-antigenic and must not be given to patients
who have anemia, increased blood volume, or congestive heart failure.
LIPIDS
Lipids are a fat emulsion that is given when IV therapy extends for longer than
five days. This is used for prolonged parenteral nutrition to provide essential
fatty acids.
Blood and Blood Products
Blood and blood products consist of whole blood, packed red blood cells, plasma,
and albumin. Whole blood consists of all cellular and plasma components of
blood. Whole blood should be used to treat severe cases of anemia—not mild
cases of anemia—because one unit of whole blood elevates hemoglobin by 0.5
to 1.0 g. (By comparison, a unit of packed red bloods elevates the hematocrit—
percentage of serum occupied by red blood cells—by three points.) Packed red
blood cells are whole blood without plasma and are used to decrease circulatory
overload and to decrease the risk of reaction to antigens contained in plasma.
Fluid Replacement
The amount of water a patient requires each day depends on the patient’s age and
the nature of the patient’s medical condition. Water is 30 mL/kg of body weight.
CHAPTER 10 Fluid and Electrolyte Therapy^161