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Fluid resuscitation and haemotherapy in the intensive care from the perspective of nurse
 NĚMCOVÁ, Kateřina
This thesis focuses on the fluid replacement therapies and the use of blood products in intensive care which is part of the daily routine for the mutidisciplinary team on intensive care including the intensive care nursing staff. These therapies span wide array of functions, including but not limited to fluid status management, electrolyte replacement and optimisation, therapeutic purposes and the delivery of nutritional requirements. The administration of blood products is vital in modern day medicine, partyicularly in the intensive care setting, and although there has been significant improvements in the standard of safety it is not completely without risk. The role of the intensive care nurse is vital not only in the preparation and administraton of blood products but also to watch for potential complications and side effects that may arise. They are also responsible for meticulous care of venous access ports as these are frequently used in the intensive care setting and must be well looked after to ensure patency and to prevent infection. This thesis is divided into parts in an attempt to cover the main issues surrounding fluid managemnet and the administration of blood products. The first part aims to summarise the relevant physiology underlying fluid balance, transfusion medicine and homeostasis. Next, based on reviewing the current literature, we aim to describe the current terminology approaches to fluid management and summarise the most commonly used products. The following sections are written with a focus on nursing care the tasks involved and their responsibilities and an overview of the possible complications that may arise with fluid replacement strategies. The important aspects of transfusion medicine are described by first defining the available blood products commonly used on intensive care followed by the basic principles underpinning the indications for their usage. We go on further to highlight the possible complications of these respective therapies and what nursing staff should be vigilant for when involved in the care of patients receiving blood products. We also address the role of the nurse in the care of the patient in hypovolemic shock. This encompasses the principles and therapies previously described in an acute setting. We describe the principles of management of such patients together with the clinical implications and practical considerations that need to be taken into account. We also focus on the particular responsibilities of the nurse in the care of such patients on intensive care. At the end of this thesis we summarised the safe concept of intravenous therapy. The second aim of this paper was based on the literature search to summarise and compare modern trends in fluid management.
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