ringer's lactate without sugar

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ringer's lactate without sugar

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tolito
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08/16/06 - 11:49 PM

why the stress 'without sugar' in kaplan???

why dont we want the sugar in cases of trauma?

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nadiabarati

08/17/06 - 08:04 AM

in trauma there is endocrine response, increase glucose level under cortisol, catecholamine , GH etc with insuline resistance to provide glucose for non insuline dependent organs which readily pick up glucose like Rbc wbc and wounded tissue. it is normal physiologic response.
increase glucose is nidus for infection, in dx5% water will increase the extravascular vol rather intravascular. so don't use glu in lactate .

tolito
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08/17/06 - 06:32 PM

thanks. good explanation.

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mph
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08/29/06 - 06:18 PM

I think the main reason to restrict sugar in trauma(esp. people who needs fluid resuscitation like ringer lactate) is not bcz stress factor or bacterial factor. Rather, it's bcz u can no longer use urine output to monitor fluid status anymore if u use sugar(diuresis).

study_ing
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08/31/06 - 02:39 AM

agreed with mph..cant remeber where i read that though..

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tolito
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08/31/06 - 07:30 AM

sounds good too. thanks.

i wonder though, we know D5W does not stay in intrav compartement, so how is it going to cause diuresis? is that as a consequence of hyperglycemia and glycosuria?

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ethics
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09/06/06 - 01:02 PM

i feel that no d5 in trauma b'coz it causes osmotic diuresis and monitoring of pats urine output would be difficult

webjeee
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12/03/06 - 08:28 PM

study_ing wrote:
agreed with mph..cant remeber where i read that though..

it's on Kaplan notes

jamaisvu
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01/01/07 - 06:57 PM

hi guyz iam a newbie for this forum
actually in the true trauma setting they use d5w 1\2 or 1\3 NS only
and use d5w rl if there is bicarb deficit
check americane guiedline"current clinical stratigies for surgery"

hanialkhadher
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01/03/07 - 05:15 AM

#10

I HAVE "current clinical stratigies for surgery" AND I DONT SEE ANY SUGER IN THE TRUMA OR SHOCK SETTINGS.
RINGER OR NS IS RECOMMENDED"current clinical stratigies for surgery"2006, ALSO IN"CURRENDT DIAGNOSIS&TREATMENT"2004.THEY RELATE IT TO:
1-OSMOTIC DIURESIS BY GLUCOSE IS MISSLEADING.
2-WATER WILL NOT BE EFFECTIVE IN RESTOREING THE BLOOD VOLUME.

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