302 Fluid balance in times of stress

Question 1

What is the difference between hypovolaemia and dehydration?

Answer 1

Hypovolaemia:
- Loss of Na and Water
- Cardiovascular derangement

Dehydration:
- Loss of Water
- Biochemical derangement (Increased Na)
- CV instability may/may not be present

Question 2

What are crystalloid fluids?

Answer 2

Intravascular admin
Electrolytes maintain tonicity
Fluid redistributes though ECF space

Made up of small, water soluble molecules

Question 3

What are colloid fluids?

Answer 3

Albumin (4.5% or 20%)
Blood products (FFP, etc)
High oncotic pressure
Plasma “expansion” or restoration

Eg.
starches, dextrans, gelatins, human albumin, or fresh frozen plasma (FFP)

Question 4

What is Multiple Organ Dysfunction Syndrome (MODS)?

Answer 4

Altered organ function (2+) in acutely ill patient which cannot be maintained without support

Question 5

What is the management of (severe sepsis) MODS?

Answer 5

Early recognition
Early resuscitation
Early definitive treatment
Supportive evidence based care
Management of pre-morbidities
Prevention of secondary insults