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<title>Fluid replacement</title>

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<span id="openzim-page-title" class="mw-page-title-main"><span class="mw-page-title-main">Fluid replacement</span></span>

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</style><table class="infobox"><tbody><tr><th colspan="2" class="infobox-above" style="background-color: lightblue">Fluid replacement</th></tr><tr><td colspan="2" class="infobox-image"><div class="infobox-caption">A <a href="Cholera" title="Cholera">cholera</a> patient drinking an oral rehydration solution (ORS)</div></td></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">Fluid resuscitation</td></tr></tbody></table>

<p><b>Fluid replacement</b> or <b>fluid resuscitation</b> is the medical practice of replenishing bodily fluid lost through sweating, bleeding, fluid shifts or other pathologic processes. Fluids can be replaced with <a href="Oral_rehydration_therapy" title="Oral rehydration therapy">oral rehydration therapy</a> (drinking), <a href="Intravenous_therapy" title="Intravenous therapy">intravenous therapy</a>, rectally such as with a <a href="Murphy_drip" title="Murphy drip">Murphy drip</a>, or by <i><a href="Hypodermoclysis" class="mw-redirect" title="Hypodermoclysis">hypodermoclysis</a></i>, the direct injection of fluid into the subcutaneous tissue. Fluids administered by the oral and hypodermic routes are absorbed more slowly than those given intravenously.

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<div class="mw-heading mw-heading2"><h2 id="By_mouth">By mouth</h2></div>

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</style><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="Oral_rehydration_therapy" title="Oral rehydration therapy">Oral rehydration therapy</a></div>

<p><a href="Oral_rehydration_therapy" title="Oral rehydration therapy">Oral rehydration therapy</a> (ORT) is a simple treatment for <a href="Dehydration" title="Dehydration">dehydration</a> associated with <a href="Diarrhea" title="Diarrhea">diarrhea</a>, particularly <a href="Gastroenteritis" title="Gastroenteritis">gastroenteritis</a>/gastroenteropathy, such as that caused by <a href="Cholera" title="Cholera">cholera</a> or <a href="Rotavirus" title="Rotavirus">rotavirus</a>. ORT consists of a <a href="Solution_(chemistry)" title="Solution (chemistry)">solution</a> of <a href="Salt_(chemistry)" title="Salt (chemistry)">salts</a> and <a href="Sugars" class="mw-redirect" title="Sugars">sugars</a> which is taken <a href="Route_of_administration#Enteral" title="Route of administration">by mouth</a>. For most mild to moderate dehydration in children, the preferable treatment in an <a href="Emergency_department" title="Emergency department">emergency department</a> is ORT over intravenous replacement of fluid.<sup id="cite_ref-ACEPfive_1-0" class="reference"><a href="#cite_note-ACEPfive-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup>

</p><p>It is used around the world, but is most important in the <a href="Developing_country" title="Developing country">developing world</a>, where it saves millions of children a year from death due to <a href="Diarrhea" title="Diarrhea">diarrhea</a>—the second leading cause of death in children under five.<sup id="cite_ref-unicef_sowc_2-0" class="reference"><a href="#cite_note-unicef_sowc-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup>

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<div class="mw-heading mw-heading2"><h2 id="Intravenous">Intravenous</h2></div>

<div role="note" class="hatnote navigation-not-searchable">Main article: <a href="Intravenous_therapy" title="Intravenous therapy">Intravenous therapy</a></div>

<th colspan="2">Daily requirements

</th></tr>

<tr>

<td>Water</td>

<td>30 ml/kg/24 h

</td></tr>

<tr>

<td>~ 1 mmol/kg/24 h

</td></tr>

<tr>

<td>~ 1 mmol/kg/24 h

</td></tr>

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<td><a href="Glucose" title="Glucose">Glucose</a></td>

<td>5 (3 to 8) g/hour

</td></tr></tbody></table>

<p>Similar precaution should be taken in administration of resuscitation fluid as to drug prescription. Fluid replacement should be considered as part of the complex physiological in the human body. Therefore, fluid requirements should be adjusted from time to time in those who are severely ill.<sup id="cite_ref-Myburgh_2013_3-0" class="reference"><a href="#cite_note-Myburgh_2013-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup>

</p><p>In severe <a href="Dehydration" title="Dehydration">dehydration</a>, <a href="Intravenous" class="mw-redirect" title="Intravenous">intravenous</a> fluid replacement is preferred, and may be lifesaving. It is especially useful where there is depletion of fluid both in the <a href="Intracellular_space" title="Intracellular space">intracellular space</a> and the <a href="Vascular_space" class="mw-redirect" title="Vascular space">vascular spaces</a>.

</p><p>Fluid replacement is also indicated in fluid depletion due to hemorrhage, extensive burns and excessive sweating (as from a prolonged fever), and prolonged diarrhea (cholera).

</p><p>During surgical procedures, fluid requirement increases by increased evaporation, <a href="Fluid_shift" class="mw-redirect" title="Fluid shift">fluid shifts</a>, or excessive urine production, among other possible causes. Even a small surgery may cause a loss of approximately 4 ml/kg/hour, and a large surgery approximately 8 ml/kg/hour, in addition to the basal fluid requirement.

</p><p>The table to the right shows daily requirements for some major fluid components. If these cannot be given enterally, they may need to be given entirely intravenously. If continued long-term (more than approx. 2 days), a more complete regimen of <a href="Total_parenteral_nutrition" class="mw-redirect" title="Total parenteral nutrition">total parenteral nutrition</a> may be required.

</p>

<div class="mw-heading mw-heading3"><h3 id="Types">Types</h3></div>

<p>Resuscitation fluid can be broadly classified into: albumin solution, semisynthetic colloids, and crystalloids.<sup id="cite_ref-Myburgh_2013_3-1" class="reference"><a href="#cite_note-Myburgh_2013-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup>

</p><p>The types of intravenous fluids used in fluid replacement are generally within the class of <a href="Volume_expander" title="Volume expander">volume expanders</a>. Physiologic <a href="Saline_(medicine)" title="Saline (medicine)">saline solution</a>, or 0.9% <a href="Sodium_chloride" title="Sodium chloride">sodium chloride</a> solution, is often used because it is <a href="Isotonicity" class="mw-redirect" title="Isotonicity">isotonic</a>, and therefore will not cause potentially dangerous <i>fluid shifts</i>. Also, if it is anticipated that blood will be given, normal saline is used because it is the only fluid compatible with blood administration.

</p><p><a href="Blood_transfusion" title="Blood transfusion">Blood transfusion</a> is the only approved fluid replacement capable of carrying oxygen; some oxygen-carrying <a href="Blood_substitute" title="Blood substitute">blood substitutes</a> are under development.

</p><p><a href="Lactated_Ringer's_solution" class="mw-redirect" title="Lactated Ringer's solution">Lactated Ringer's solution</a> is another isotonic crystalloid solution and it is designed to match most closely <a href="Blood_plasma" title="Blood plasma">blood plasma</a>. If given intravenously, isotonic crystalloid fluids will be distributed to the intravascular and interstitial spaces.

</p><p><a href="Plasma-lyte" title="Plasma-lyte">Plasmalyte</a> is another isotonic crystalloid.

</p><p>Blood products, non-blood products and combinations are used in fluid replacement, including <a href="Colloid" title="Colloid">colloid</a> and crystalloid solutions. Colloids are increasingly used but they are more expensive than crystalloids. A <a href="Systematic_review" title="Systematic review">systematic review</a> found no evidence that resuscitation with colloids, instead of crystalloids, reduces the risk of death in patients with trauma or burns, or following surgery.<sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup>

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<div class="mw-heading mw-heading3"><h3 id="Maintenance">Maintenance</h3></div>

<p>Maintenance fluids are used in those who are currently normally hydrated but unable to drink enough to maintain this hydration. In children <a href="Isotonic_fluid" class="mw-redirect" title="Isotonic fluid">isotonic fluids</a> are generally recommended for maintaining hydration.<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Fel2018_6-0" class="reference"><a href="#cite_note-Fel2018-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> <a href="Potassium_chloride" title="Potassium chloride">Potassium chloride</a> and <a href="Dextrose" class="mw-redirect" title="Dextrose">dextrose</a> should be included.<sup id="cite_ref-Fel2018_6-1" class="reference"><a href="#cite_note-Fel2018-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> The amount of maintenance IV fluid required in 24 hours is based on the weight of the patient using the <a href="Holliday-Segar_formula" title="Holliday-Segar formula">Holliday-Segar formula</a>.<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> For weights ranging from 0 to 10 kg, the caloric expenditure is 100 cal/kg/day; from 10 to 20 kg the caloric expenditure is 1000 cal plus 50 cal/kg for each kilogram of body weight more than 10; over 20 kg the caloric expenditure is 1500 cal plus 20 cal/kg for each kilogram more than 20. More complex calculations (e.g., those using body surface area) are rarely required.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading3"><h3 id="Procedure">Procedure</h3></div>

<p>It is important to achieve a fluid status that is good enough to avoid <a href="Oliguria" title="Oliguria">low urine production</a>. Low urine output has various limits, and varies for children, infants, and adults (see <a href="Oliguria" title="Oliguria">low urine production</a>). The <a href="Parkland_formula" title="Parkland formula">Parkland formula</a> is not perfect and fluid therapy will need to be titrated to hemodynamic values and urine output.

</p><p>The speed of fluid replacement may differ between procedures. For example, the planning of fluid replacement for <a href="Burn" title="Burn">burn</a> patients is based on the Parkland formula (4mL Lactated Ringers X weight in kg X % total body surface area burned = Amount of fluid ( in ml) to give over 24 hours). The Parkland formula gives the minimum amount to be given in 24 hours. Half of the volume is given over the first eight hours after the time of the burn (not from time of admission to hospital) and the other half over the next 16 hours. In dehydration, 2/3 of the deficit may be given in 4 hours, and the rest during approximately 20 hours.

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<div class="mw-heading mw-heading2"><h2 id="Clinical_uses">Clinical uses</h2></div>

<div class="mw-heading mw-heading3"><h3 id="Septic_shock">Septic shock</h3></div>

<p>Fluid replacement in patients with <a href="Septic_shock" title="Septic shock">septic shock</a> can be divided into four stages as shown below:

</p>

<ul><li><b>Resuscitation phase</b> - The goal of this phase is to correct the <a href="Hypotension" title="Hypotension">hypotension</a>. Intravenous <a href="Crystalloid_solution" class="mw-redirect" title="Crystalloid solution">crystalloid</a> is the first choice of therapy. <a href="Surviving_Sepsis_Campaign" title="Surviving Sepsis Campaign">Surviving Sepsis Campaign</a> recommends 30 ml/kg fluid resuscitation in this phase. Earlier fluid resuscitation is associated with improved survival. <a href="Mean_arterial_pressure" title="Mean arterial pressure">Mean arterial pressure</a> should be targeted at more than 65 mmHg.<sup id="cite_ref-Ogbonna_2015_10-0" class="reference"><a href="#cite_note-Ogbonna_2015-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> Meanwhile, for early goal directed therapy (EGDT), fluids should be administered within the first six hours of septic shock until central venous pressure (CVP) reaches between 8 and 12 mmHg, with improvement of blood <a href="Lactic_acid" title="Lactic acid">lactate</a> levels, central venous oxygen saturation > 70%, and urine output ≥ 0.5 ml/kg/hour.<sup id="cite_ref-Robert_2010_11-0" class="reference"><a href="#cite_note-Robert_2010-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Higher mean arterial pressures can be used in patients with chronic hypertension in order to reduce the usage of <a href="Renal_replacement_therapy" title="Renal replacement therapy">renal replacement therapy</a>. However, if fluid replacement is inadequate in raising blood pressure, then <a href="Vasopressor" class="mw-redirect" title="Vasopressor">vasopressor</a> have to be used. However, there is no definite timing of starting vasopressors. Initiation of vasopressors within the first hour of sepsis can lead to poor organ perfusion and poor organ function. Late initiation of vasopressor can lead to organ damage and increase the risk of death. Frequent monitoring of fluid status of the patient is required to prevent fluid overload.<sup id="cite_ref-Ogbonna_2015_10-1" class="reference"><a href="#cite_note-Ogbonna_2015-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup></li>

<li><b>Optimisation phase</b> - In this phase, the goal is to increase the oxygen delivery to tissues in order to meet the oxygen demands of the tissues. Oxygen delivery can be improved by increasing <a href="Stroke_volume" title="Stroke volume">stroke volume</a> of the heart (through fluid challenge), <a href="Haemoglobin" class="mw-redirect" title="Haemoglobin">haemoglobin</a> concentration (through <a href="Blood_transfusion" title="Blood transfusion">blood transfusion</a>), and arterial oxygen saturation (through <a href="Oxygen_therapy" title="Oxygen therapy">oxygen therapy</a>). Fluid challenge is the procedure of giving large amounts of fluid in a short period of time.<sup id="cite_ref-Vincent2006_12-0" class="reference"><a href="#cite_note-Vincent2006-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> However, 50% of patients do not respond to fluid challenge. Additional fluid challenges only causes fluid overload. However, there is no gold standard on determining the fluid responsiveness. Among other ways of determining the fluid responsiveness and the end point of fluid resuscitation are: Central venous <a href="Oxygen_saturation_(medicine)" title="Oxygen saturation (medicine)">oxygen saturation</a> (ScvO2), <a href="Passive_leg_raising_test" class="mw-redirect" title="Passive leg raising test">passive leg raising test</a>, ultrasound measurements of <a href="Pulse_pressure" title="Pulse pressure">pulse pressure</a> variation, stroke volume variation, and respiratory variations at <a href="Superior_vena_cava" title="Superior vena cava">superior vena cava</a>, <a href="Inferior_vena_cava" title="Inferior vena cava">inferior vena cava</a> and <a href="Internal_jugular_vein" title="Internal jugular vein">internal jugular vein</a>.<sup id="cite_ref-Ogbonna_2015_10-2" class="reference"><a href="#cite_note-Ogbonna_2015-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup></li>

<li><b>Stabilisation phase</b> - In this stage, the tissue perfusion starts to stabilise and the need of fluid or vasopressors starts reducing. Additional fluid challenges can be given only for those who are responsive. Maintenance fluid can be stopped if the perfusion status is adequate.<sup id="cite_ref-Ogbonna_2015_10-3" class="reference"><a href="#cite_note-Ogbonna_2015-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup></li>

<li><b>Evacuation phase</b> - In this phase, the goal is to remove excessive fluids from those who achieved adequate tissue perfusion. Negative fluid balance is associated with decreased risk of death. However, there is no consensus regarding the optimal timing for fluid removal and risk of reduced perfusion following fluid removal is also inconclusive. A reasonable approach is to begin fluid restriction when the tissue perfusion is adequate, and consider diuretic treatment for those with clinical evidence of fluid overload and positive fluid balance. According to Fluid and Catheter Treatment Trial (FACTT Trial) protocol, those who with mean arterial pressure of more than 60 mmHg, vasopressor free for more than 12 hours, with adequate urine output can be given <a href="Furosemide" title="Furosemide">furosemide</a> to target <a href="Central_venous_pressure" title="Central venous pressure">central venous pressure</a> less than 4 mmHg and pulmonary artery occlusion pressure (PAOP) of less than 8 mmHg. The levels of <a href="Brain_natriuretic_peptide" class="mw-redirect" title="Brain natriuretic peptide">Brain natriuretic peptide</a> can also be used to guide fluid removal.<sup id="cite_ref-Ogbonna_2015_10-4" class="reference"><a href="#cite_note-Ogbonna_2015-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup></li></ul>

<div class="mw-heading mw-heading3"><h3 id="Acute_kidney_injury">Acute kidney injury</h3></div>

<p>Sepsis accounts for 50% of acute kidney injury patients in (<a href="Intensive_care_unit" title="Intensive care unit">intensive care unit</a>) (ICU).<sup id="cite_ref-Robert_2010_11-1" class="reference"><a href="#cite_note-Robert_2010-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Intravenous <a href="Crystalloid_solution" class="mw-redirect" title="Crystalloid solution">crystalloid</a> is recommended as the first line therapy to prevent or to treat acute kidney injury (AKI) when compared to <a href="Colloid" title="Colloid">colloids</a> as colloids increases the risk of AKI.<sup id="cite_ref-Claire_2013_13-0" class="reference"><a href="#cite_note-Claire_2013-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> 4% human albumin may be used in cirrhotic patients with <a href="Spontaneous_bacterial_peritonitis" title="Spontaneous bacterial peritonitis">spontaneous bacterial peritonitis</a> as it can reduce the rate of <a href="Kidney_failure" title="Kidney failure">kidney failure</a> and improve survival.<sup id="cite_ref-Robert_2010_11-2" class="reference"><a href="#cite_note-Robert_2010-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> However, fluid overload can exacerbate acute kidney injury. The use of diuretics does not prevent or treat AKI even with the help of <a href="Renal_replacement_therapy" title="Renal replacement therapy">renal replacement therapy</a>. The 2012 KDIGO (Kidney Disease: Improving Global Outcomes) guidelines stated that diuretics should not be used to treat AKI, except for the management of volume overload.<sup id="cite_ref-Claire_2013_13-1" class="reference"><a href="#cite_note-Claire_2013-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> In <a href="Acute_respiratory_distress_syndrome" title="Acute respiratory distress syndrome">acute respiratory distress syndrome</a> (ARDS), conservative fluid management is associated with better oxygenation and lung function with less prevalence of dialysis in the first 60 days of hospitalization when compared with liberal fluid management.<sup id="cite_ref-Robert_2010_11-3" class="reference"><a href="#cite_note-Robert_2010-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading3"><h3 id="Surgery_(perioperative_fluid_therapy)">Surgery (perioperative fluid therapy)</h3></div>

<p>Managing fluids during major surgical procedures is an important aspect of surgical care.<sup id="cite_ref-:0_14-0" class="reference"><a href="#cite_note-:0-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> The goal of fluid therapy is to maintain fluid and electrolyte levels and restore levels that may be depleted.<sup id="cite_ref-:0_14-1" class="reference"><a href="#cite_note-:0-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> Intravenous fluid therapy is used when a person cannot control their own fluid intake and it can also reduce nausea and vomiting.<sup id="cite_ref-:0_14-2" class="reference"><a href="#cite_note-:0-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> Goal-directed fluid therapy is a perioperative strategy in which the person is administered fluids continuously and the amount of fluids given are based on the person's physiological and <a href="Hemodynamics" title="Hemodynamics">haemodynamic</a> (blood flow) measurements.<sup id="cite_ref-:0_14-3" class="reference"><a href="#cite_note-:0-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> A second approach to fluid management during surgical procedures is called perioperative restrictive fluid therapy, also known as near-zero or zero-balance perioperative fluid approach; this approach recommends lower amounts of fluids during surgery, replacing fluids when the person is low (basal fluid requirements) or loses fluid due to a surgical procedure or bleed.<sup id="cite_ref-:0_14-4" class="reference"><a href="#cite_note-:0-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> The effectiveness of goal-directed fluid therapy compared to restrictive fluid therapy is not clear as evidence comparing both approaches have very low certainty.<sup id="cite_ref-:0_14-5" class="reference"><a href="#cite_note-:0-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading2"><h2 id="Fluid_overload">Fluid overload</h2></div>

<p>Fluid overload is defined as an increase in body weight of over 10%.<sup id="cite_ref-Robert_2010_11-4" class="reference"><a href="#cite_note-Robert_2010-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Aggressive fluid resuscitation can lead to fluid overload which can lead to damage of multiple organs: cerebral oedema, which leads to <a href="Delirium" title="Delirium">delirium</a>; <a href="Pulmonary_oedema" class="mw-redirect" title="Pulmonary oedema">pulmonary oedema</a> and <a href="Pleural_effusion" title="Pleural effusion">pleural effusion</a>, which lead to respiratory distress; myocardial oedema and <a href="Pericardial_effusion" title="Pericardial effusion">pericardial effusion</a>, which lead to impaired contractility of the heart; gastrointestinal oedema, which leads to malabsorption; hepatic congestion, which leads to <a href="Cholestasis" title="Cholestasis">cholestasis</a> and <a href="Acute_kidney_injury" title="Acute kidney injury">acute kidney injury</a>; and tissue oedema, which leads to poor wound healing. All these effects can cause disability and death, and increase in hospitalisation costs.<sup id="cite_ref-Ogbonna_2015_10-5" class="reference"><a href="#cite_note-Ogbonna_2015-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup>

</p><p>Fluid overload causes cardiac dilation, which leads to increased ventricular wall stress, mitral insufficiency and leads to cardiac dysfunction. <a href="Pulmonary_hypertension" title="Pulmonary hypertension">Pulmonary hypertension</a> can lead to tricuspid insufficiency. Excess administration of fluid causes accumulation of <a href="Extracellular_fluid" title="Extracellular fluid">extracellular fluid</a>, leading to pulmonary oedema and lack of oxygen delivery to tissues. The use of mechanical ventilation in such case can cause <a href="Barotrauma" title="Barotrauma">barotrauma</a>, infection, and <a href="Oxygen_toxicity" title="Oxygen toxicity">oxygen toxicity</a>, leading to acute respiratory distress syndrome.<sup id="cite_ref-Robert_2010_11-5" class="reference"><a href="#cite_note-Robert_2010-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Fluid overload also stretches the arterial <a href="Endothelium" title="Endothelium">endothelium</a>, which causes damage to the <a href="Glycocalyx" title="Glycocalyx">glycocalyx</a>, leading to capillary leakage and worsens the acute kidney injury.<sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading2"><h2 id="Other_treatments">Other treatments</h2></div>

<p>Proctoclysis, an enema, is the administration of fluid into the rectum as a hydration therapy. It is sometimes used for very ill persons with cancer.<sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> The <a href="Murphy_drip" title="Murphy drip">Murphy drip</a> is a device by means of which this treatment may be performed.

</p>

<ul><li><a href="Hypodermoclysis" class="mw-redirect" title="Hypodermoclysis">Hypodermoclysis</a></li>

<li><a href="Intravenous_therapy" title="Intravenous therapy">Intravenous therapy</a></li>

<li><a href="Hypovolemia" title="Hypovolemia">Hypovolemia</a></li>

<li><a href="Third_spacing" class="mw-redirect" title="Third spacing">Third spacing</a></li>

<li><a href="Pentastarch" title="Pentastarch">Pentastarch</a></li>

<li><a href="Passive_leg_raising_test" class="mw-redirect" title="Passive leg raising test">Passive leg raising test</a></li></ul>

<div class="mw-heading mw-heading2"><h2 id="References">References</h2></div>

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</style><cite class="citation cs2"><a rel="nofollow" class="external text" href="http://www.choosingwisely.org/doctor-patient-lists/american-college-of-emergency-physicians/">"Ten Things Physicians and Patients Should Question"</a>, <i><a href="Choosing_Wisely" title="Choosing Wisely">Choosing Wisely</a></i>, <a href="American_College_of_Emergency_Physicians" title="American College of Emergency Physicians">American College of Emergency Physicians</a>, October 27, 2014 [October 14, 2013]<span class="reference-accessdate">, retrieved <span class="nowrap">April 6,</span> 2015</span></cite>, which cites:

<ul><li><cite id="CITEREFHartlingBellemareWiebeRussell2006" class="citation journal cs1">Hartling, L; Bellemare, S; Wiebe, N; Russell, KF; et al. (2006). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6532593">"Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children"</a>. <i><a href="Cochrane_Library" title="Cochrane Library">Cochrane Database of Systematic Reviews</a></i>. <b>2006</b> (3): CD004390. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2F14651858.CD004390.pub2">10.1002/14651858.CD004390.pub2</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6532593">6532593</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16856044">16856044</a>.</cite></li></ul>

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<li id="cite_note-unicef_sowc-2"><span class="mw-cite-backlink"><b><a href="#cite_ref-unicef_sowc_2-0">^</a></b></span> <span class="reference-text"><cite class="citation book cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20171208022120/https://www.unicef.org/publications/files/The_State_of_the_Worlds_Children_2008.pdf"><i>The State of the World's Children 2008: Child Survival</i></a> <span class="cs1-format">(PDF)</span>. <a href="UNICEF" title="UNICEF">UNICEF</a>. December 2007. p. 8. <a href="ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <bdi>9789280641912</bdi>. Archived from <a rel="nofollow" class="external text" href="http://www.unicef.org/publications/files/The_State_of_the_Worlds_Children_2008.pdf">the original</a> <span class="cs1-format">(PDF)</span> on December 8, 2017<span class="reference-accessdate">. Retrieved <span class="nowrap">February 16,</span> 2009</span>.</cite></span>

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<li id="cite_note-Myburgh_2013-3"><span class="mw-cite-backlink">^ <a href="#cite_ref-Myburgh_2013_3-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Myburgh_2013_3-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><cite id="CITEREFMyburghMythen2013" class="citation journal cs1">Myburgh, John A.; Mythen, Michael G. (2013-09-26). <a rel="nofollow" class="external text" href="https://doi.org/10.1056%2FNEJMra1208627">"Resuscitation Fluids"</a>. <i>New England Journal of Medicine</i>. <b>369</b> (13): <span class="nowrap">1243–</span>1251. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1056%2FNEJMra1208627">10.1056/NEJMra1208627</a></span>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/0028-4793">0028-4793</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/24066745">24066745</a>.</cite></span>

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<li id="cite_note-4"><span class="mw-cite-backlink"><b><a href="#cite_ref-4">^</a></b></span> <span class="reference-text"><cite id="CITEREFLewisPritchardEvansButler2018" class="citation journal cs1">Lewis, Sharon R.; Pritchard, Michael W.; Evans, David Jw; Butler, Andrew R.; Alderson, Phil; Smith, Andrew F.; Roberts, Ian (3 August 2018). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6513027">"Colloids versus crystalloids for fluid resuscitation in critically ill people"</a>. <i>The Cochrane Database of Systematic Reviews</i>. <b>8</b> (8): CD000567. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2F14651858.CD000567.pub7">10.1002/14651858.CD000567.pub7</a>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1469-493X">1469-493X</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6513027">6513027</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/30073665">30073665</a>.</cite></span>

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<li id="cite_note-5"><span class="mw-cite-backlink"><b><a href="#cite_ref-5">^</a></b></span> <span class="reference-text"><cite id="CITEREFMcNabWareNevilleChoong2014" class="citation journal cs1">McNab, S; Ware, RS; Neville, KA; Choong, K; et al. (2014). <a rel="nofollow" class="external text" href="https://espace.library.uq.edu.au/view/UQ:353670/UQ353670_OA.pdf">"Isotonic versus hypotonic solutions for maintenance intravenous fluid administration in children"</a> <span class="cs1-format">(PDF)</span>. <i><a href="Cochrane_Library" title="Cochrane Library">Cochrane Database of Systematic Reviews</a></i>. <b>2014</b> (12): CD009457. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2F14651858.CD009457.pub2">10.1002/14651858.CD009457.pub2</a>. <a href="Hdl_(identifier)" class="mw-redirect" title="Hdl (identifier)">hdl</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://hdl.handle.net/10072%2F172363">10072/172363</a></span>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10837683">10837683</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/25519949">25519949</a>.</cite></span>

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<li id="cite_note-Fel2018-6"><span class="mw-cite-backlink">^ <a href="#cite_ref-Fel2018_6-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Fel2018_6-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><cite id="CITEREFFeldNeuspielFosterLeu2018" class="citation journal cs1">Feld, LG; Neuspiel, DR; Foster, BA; Leu, MG; Garber, MD; Austin, K; Basu, RK; Conway EE, Jr; Fehr, JJ; Hawkins, C; Kaplan, RL; Rowe, EV; Waseem, M; Moritz, ML; SUBCOMMITTEE ON FLUID AND ELECTROLYTE, THERAPY. (December 2018). <a rel="nofollow" class="external text" href="https://doi.org/10.1542%2Fpeds.2018-3083">"Clinical Practice Guideline: Maintenance Intravenous Fluids in Children"</a>. <i>Pediatrics</i>. <b>142</b> (6): e20183083. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1542%2Fpeds.2018-3083">10.1542/peds.2018-3083</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/30478247">30478247</a>.</cite></span>

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<li id="cite_note-7"><span class="mw-cite-backlink"><b><a href="#cite_ref-7">^</a></b></span> <span class="reference-text"><cite id="CITEREFHollidaySegar1957" class="citation journal cs1">Holliday, M. A.; Segar, W. E. (1957). "The maintenance need for water in parenteral fluid therapy". <i>Pediatrics</i>. <b>19</b> (5): <span class="nowrap">823–</span>832. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1542%2Fpeds.19.5.823">10.1542/peds.19.5.823</a>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/0031-4005">0031-4005</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/13431307">13431307</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:245056959">245056959</a>.</cite></span>

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<li id="cite_note-8"><span class="mw-cite-backlink"><b><a href="#cite_ref-8">^</a></b></span> <span class="reference-text"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.merckmanuals.com/professional/multimedia/table/v1089210">"Table: Holliday-Segar Formula for Maintenance Fluid Requirements by Weight"</a>. <i>Merck Manuals Professional Edition</i><span class="reference-accessdate">. Retrieved <span class="nowrap">2021-01-12</span></span>.</cite></span>

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<li id="cite_note-9"><span class="mw-cite-backlink"><b><a href="#cite_ref-9">^</a></b></span> <span class="reference-text"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.merckmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/dehydration-in-children?query=holliday%20segar">"Dehydration in Children - Pediatrics"</a>. <i>Merck Manuals Professional Edition</i><span class="reference-accessdate">. Retrieved <span class="nowrap">2021-01-12</span></span>.</cite></span>

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<li id="cite_note-Ogbonna_2015-10"><span class="mw-cite-backlink">^ <a href="#cite_ref-Ogbonna_2015_10-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Ogbonna_2015_10-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Ogbonna_2015_10-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-Ogbonna_2015_10-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-Ogbonna_2015_10-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-Ogbonna_2015_10-5"><sup><i><b>f</b></i></sup></a></span> <span class="reference-text"><cite id="CITEREFC_OgbuJ_MurphyS_Martin2015" class="citation journal cs1">C Ogbu, Ogbonna; J Murphy, David; S Martin, Greg (August 2015). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4691845">"How to Avoid Fluid Overload"</a>. <i>Current Opinion in Critical Care</i>. <b>21</b> (4): <span class="nowrap">315–</span>321. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1097%2FMCC.0000000000000211">10.1097/MCC.0000000000000211</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4691845">4691845</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/26103147">26103147</a>.</cite></span>

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<li id="cite_note-Robert_2010-11"><span class="mw-cite-backlink">^ <a href="#cite_ref-Robert_2010_11-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Robert_2010_11-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Robert_2010_11-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-Robert_2010_11-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-Robert_2010_11-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-Robert_2010_11-5"><sup><i><b>f</b></i></sup></a></span> <span class="reference-text"><cite id="CITEREFW_Schrier2010" class="citation journal cs1">W Schrier, Robert (2010). <a rel="nofollow" class="external text" href="https://doi.org/10.2215%2FCJN.00060110">"Fluid Administration in Critically Ill Patients with Acute Kidney Injury"</a>. <i>Clinical Journal of the American Society of Nephrology</i>. <b>5</b> (4): <span class="nowrap">733–</span>739. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.2215%2FCJN.00060110">10.2215/CJN.00060110</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/20167687">20167687</a>.</cite></span>

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<li id="cite_note-Vincent2006-12"><span class="mw-cite-backlink"><b><a href="#cite_ref-Vincent2006_12-0">^</a></b></span> <span class="reference-text"><cite id="CITEREFVincentWeil2006" class="citation journal cs1">Vincent, J; Weil, M (2006). "Fluid challenge revisited". <i><a href="Critical_Care_Medicine_(journal)" title="Critical Care Medicine (journal)">Critical Care Medicine</a></i>. <b>34</b> (5): <span class="nowrap">1333–</span>7. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1097%2F01.CCM.0000214677.76535.A5">10.1097/01.CCM.0000214677.76535.A5</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16557164">16557164</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:41215136">41215136</a>.</cite></span>

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<li id="cite_note-Claire_2013-13"><span class="mw-cite-backlink">^ <a href="#cite_ref-Claire_2013_13-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Claire_2013_13-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><cite id="CITEREFClaireFredetteBouchard2013" class="citation journal cs1">Claire, Annie; Fredette, Nadeau; Bouchard, Josée (January 2013). "Fluid Management and Use of Diuretics in Acute Kidney Injury". <i>Advances in Chronic Kidney Disease</i>. <b>20</b> (1): <span class="nowrap">45–</span>55. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1053%2Fj.ackd.2012.09.005">10.1053/j.ackd.2012.09.005</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23265596">23265596</a>.</cite></span>

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<li id="cite_note-:0-14"><span class="mw-cite-backlink">^ <a href="#cite_ref-:0_14-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:0_14-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-:0_14-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-:0_14-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-:0_14-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-:0_14-5"><sup><i><b>f</b></i></sup></a></span> <span class="reference-text"><cite id="CITEREFWrzosekJakowicka-WordliczekZajaczkowskaSerednicki2019" class="citation journal cs1">Wrzosek, Anna; Jakowicka-Wordliczek, Joanna; Zajaczkowska, Renata; Serednicki, Wojciech T.; Jankowski, Milosz; Bala, Malgorzata M.; Swierz, Mateusz J.; Polak, Maciej; Wordliczek, Jerzy (2019-12-12). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6953415">"Perioperative restrictive versus goal-directed fluid therapy for adults undergoing major non-cardiac surgery"</a>. <i>The Cochrane Database of Systematic Reviews</i>. <b>12</b> (12): CD012767. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2F14651858.CD012767.pub2">10.1002/14651858.CD012767.pub2</a>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1469-493X">1469-493X</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6953415">6953415</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/31829446">31829446</a>.</cite></span>

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<li id="cite_note-15"><span class="mw-cite-backlink"><b><a href="#cite_ref-15">^</a></b></span> <span class="reference-text"><cite id="CITEREFOstermannOudemans-van_StraatenG._Forni2015" class="citation journal cs1">Ostermann, Marlies; Oudemans-van Straaten, Heleen M; G. Forni, Lui (27 December 2015). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4699346">"Fluid overload and acute kidney injury: cause or consequence?"</a>. <i>Critical Care</i>. <b>19</b> 443. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1186%2Fs13054-015-1163-7">10.1186/s13054-015-1163-7</a></span>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4699346">4699346</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/26707872">26707872</a>.</cite></span>

</li>

<li id="cite_note-16"><span class="mw-cite-backlink"><b><a href="#cite_ref-16">^</a></b></span> <span class="reference-text"><cite id="CITEREFBrueraPruvostSchoellerMontejo1998" class="citation journal cs1">Bruera, E; Pruvost, M; Schoeller, T; Montejo, G; et al. (April 1998). <a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fs0885-3924%2897%2900367-9">"Proctoclysis for hydration of terminally ill cancer patients"</a>. <i><a href="Journal_of_Pain_and_Symptom_Management" title="Journal of Pain and Symptom Management">Journal of Pain and Symptom Management</a></i>. <b>15</b> (4): <span class="nowrap">216–</span>9. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fs0885-3924%2897%2900367-9">10.1016/s0885-3924(97)00367-9</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/9601155">9601155</a>.</cite></span>

</li>

</ol></div></div>

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</style><div id="Blood_transfusion_and_transfusion_medicine194" style="font-size:114%;margin:0 4em"><a href="Blood_transfusion" title="Blood transfusion">Blood transfusion</a> and <a href="Transfusion_medicine" title="Transfusion medicine">transfusion medicine</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Blood_product" title="Blood product">Blood products</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Whole_blood" title="Whole blood">Whole blood</a></li>

<li><a href="Platelet" title="Platelet">Platelets</a>

<ul><li><a href="Platelet_transfusion" title="Platelet transfusion">Platelet transfusion</a></li></ul></li>

<li><a href="Packed_red_blood_cells" title="Packed red blood cells">Red blood cells</a></li>

<li><a href="Blood_plasma" title="Blood plasma">Plasma</a>

<ul><li><a href="Fresh_frozen_plasma" title="Fresh frozen plasma">Fresh frozen plasma</a></li>

<li><a href="Cryoprecipitate" title="Cryoprecipitate">Cryoprecipitate</a></li>

<li><a href="Cryosupernatant" title="Cryosupernatant">Cryosupernatant</a></li></ul></li>

<li><a href="White_blood_cells" class="mw-redirect" title="White blood cells">White blood cells</a>

<ul><li><a href="Granulocyte_transfusion" title="Granulocyte transfusion">Granulocyte transfusion</a></li></ul></li>

<li><a href="Blood_substitute" title="Blood substitute">Blood substitutes</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">General concepts</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Blood_bank" title="Blood bank">Blood bank</a></li>

<li><a href="Blood_donation" title="Blood donation">Blood donation</a></li>

<li><a href="Blood_management" class="mw-redirect" title="Blood management">Blood management</a></li>

<li><a href="International_Society_of_Blood_Transfusion" title="International Society of Blood Transfusion">International Society of Blood Transfusion</a></li>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Methods</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Apheresis" title="Apheresis">Apheresis</a> (<a href="Plasmapheresis" title="Plasmapheresis">plasmapheresis</a>, <a href="Plateletpheresis" title="Plateletpheresis">plateletpheresis</a>, <a href="Leukapheresis" title="Leukapheresis">leukapheresis</a>)</li>

<li><a href="Exchange_transfusion" title="Exchange transfusion">Exchange transfusion</a></li>

<li><a href="Intraoperative_blood_salvage" title="Intraoperative blood salvage">Intraoperative blood salvage</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Tests</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Blood_compatibility_testing" title="Blood compatibility testing">Blood compatibility testing</a>

<ul><li><a href="Cross-matching" title="Cross-matching">Cross-matching</a></li></ul></li>

<li><a href="Coombs_test" title="Coombs test">Coombs test</a></li>

<li><a href="Kleihauer%E2%80%93Betke_test" title="Kleihauer–Betke test">Kleihauer–Betke test</a></li>

<li><a href="Antibody_elution" title="Antibody elution">Antibody elution</a></li>

<li><a href="Monocyte_monolayer_assay" title="Monocyte monolayer assay">Monocyte monolayer assay</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Transfusion_reaction" class="mw-redirect" title="Transfusion reaction">Transfusion reactions</a><br>and adverse effects</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Transfusion_hemosiderosis" title="Transfusion hemosiderosis">Transfusion hemosiderosis</a></li>

<li><a href="Transfusion_related_acute_lung_injury" class="mw-redirect" title="Transfusion related acute lung injury">Transfusion related acute lung injury</a></li>

<li><a href="Transfusion_associated_circulatory_overload" class="mw-redirect" title="Transfusion associated circulatory overload">Transfusion associated circulatory overload</a></li>

<li><a href="Transfusion-associated_graft_versus_host_disease" class="mw-redirect" title="Transfusion-associated graft versus host disease">Transfusion-associated graft versus host disease</a></li>

<li><a href="Febrile_non-hemolytic_transfusion_reaction" title="Febrile non-hemolytic transfusion reaction">Febrile non-hemolytic transfusion reaction</a></li>

<li><a href="Hemolytic" class="mw-redirect" title="Hemolytic">Hemolytic</a> reaction

<ul><li><a href="Acute_hemolytic_transfusion_reaction" title="Acute hemolytic transfusion reaction">acute</a></li>

<li><a href="Delayed_hemolytic_transfusion_reaction" title="Delayed hemolytic transfusion reaction">delayed</a></li></ul></li>

<li><a href="Serum_sickness" title="Serum sickness">Serum sickness</a></li>

<li><a href="Transfusion_transmitted_infection" class="mw-redirect" title="Transfusion transmitted infection">Transfusion transmitted infection</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Human_blood_group_systems" title="Human blood group systems">Blood group systems</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Blood_type" title="Blood type">Blood types</a></li>

<ul><li><a href="Secretor_status" title="Secretor status">Secretor status</a></li></ul></li>

<li><a href="Augustine_blood_group_system" title="Augustine blood group system">Augustine</a></li>

<li><a href="Complement_component_4" title="Complement component 4">Chido-Rodgers</a></li>

<li><a href="Colton_antigen_system" title="Colton antigen system">Colton</a></li>

<li><a href="Decay-accelerating_factor" title="Decay-accelerating factor">Cromer</a></li>

<li><a href="Diego_antigen_system" title="Diego antigen system">Diego</a></li>

<li><a href="ART4" title="ART4">Dombrock</a></li>

<li><a href="Duffy_antigen_system" title="Duffy antigen system">Duffy</a></li>

<li><a href="Glycophorin_C" title="Glycophorin C">Gerbich</a></li>

<li><a href="Indian_blood_group_system" title="Indian blood group system">Indian</a></li>

<li>KANNO</li>

<li><a href="Complement_receptor_1" title="Complement receptor 1">Knops</a></li>

<li><a href="Lewis_antigen_system" title="Lewis antigen system">Lewis</a></li>

<li><a href="Lutheran_antigen_system" title="Lutheran antigen system">Lutheran</a></li>

<li><a href="Scianna_antigen_system" title="Scianna antigen system">Scianna</a></li>

<li><a href="Human_red_cell_antigens" title="Human red cell antigens">Other</a></li></ul>

</div></td></tr></tbody></table></div></div><div><div class="zim-footer">

This article is issued from <a class="external text" title="Last edited on 2025-07-17" href="https://en.wikipedia.org/wiki/?title=Fluid_replacement&oldid=1301061115">Wikipedia</a>. The text is available under <a class="external text" href="https://creativecommons.org/licenses/by-sa/4.0/deed.en">Creative Commons Attribution-Share Alike 4.0</a> unless otherwise noted. Additional terms may apply for the media files.

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