AcidBase.Fluids.Lytes Articles 2017-2019

Question 1

JVIM 2009 What was the incidence of hypoiCa in ciritally ill dogs and what was it associated with

Answer 1

16%

Associated with increased hospital stay, but not with survivial

Question 2

JVIM 2009 Which dogs were more likely to have hypoiCa

Answer 2

renal failure, DKA, pancreatitis, sepsis

Question 3

JVIM 2009 In trauma patients what was found to have worse ouctomes

Answer 3

acidosis and hypo iCa

Question 4

JVECC 2008 How did the decrease in TP associated with an LRS 10 ml/kg/hr fluid bolus alter unmeasured anions

Answer 4

If use the prefluid TP did not alter unmeasured anions

Question 5

JVIM 2017 What are the components of a balanced cyrstalloid

Answer 5

Contain species specific lytes concentrations
Maintain or normalize acid/base balance (appropriate SID)
Isosmotic and isotonic with plasma
Consider temperature dependence of H2CO3

Question 6

JVECC 2017 Which fluid types did not support bacterial growth

Answer 6

Acetate and gluconate containing fluids

Question 7

JVECC 2017 What percentaage of fluid bags had bacterial contamination

Answer 7

4.4 % of all bags (only positive were in ER setting)
30% of all ports
Did not alcohol ports as did not want to do extra measures to prevent contamination.

Question 8

JVECC 2018 In all cause mortality what acid base status was highest

Answer 8

Lactic acidosis 59%, Dogs; 49% cats
In dogs hyperlactemia with normal acid/base increased mortality
Cat findings differ from previous study which showed no difference

Question 9

AJVR 2018 How is diaslyte Na concentration compared to patient Na concetration

Answer 9

Diaslyate Na concentration correltated with patient Na concentration in dogs
The Diaslyate to pateitn gradient may be able to predict dysnatremias
***a change in pateint Na does not predict the magnitude of Na influx during diaslysis

Question 10

JVECC 2018 How does NG tube suctions change acid base

Answer 10

It does not lead to a hyperchloremic metabolic alkalosis over a 36 hr period
NGT pH increased over time

Question 11

JVIM 2018 How did a 6% tetrastarch compare to LRS in hemorrhaged anesthetized dogs for volume resuscitation in terms of extravascular lung volume

Answer 11

TS causes less extravascular lung water than LRS, neihter had evidence of pulmonary edema

Question 12

JVIM 2018 How did a 6% tetrastarch compare to LRS in hemorrhaged anesthetized dogs for volume resuscitation in terms markers for AKI

Answer 12

Neither produced AKI as no change in plasma/urine NGAL or creatining or UNGAL/Crea ratio

Question 13

AJVR 2019 in working dogs what was used to evaluate early dehdyration

Answer 13

Delayed skin turgor measured at the sagital crest able to detect mild dehydration evidence by loss of 0.83% body weight
CRT not as strongly correlated

Question 14

AJVR 2019 How did a passive leg raise in pigs used to evaluate

Answer 14

Consistent with hypovolemia when raised at a 15 degree angle

Resulted in increase in cardiac output and decrease in pulse pressure variation

Question 15

JVECC 2019 how did fluid resuscitation strategies alter NT Pro-BNP in healthy dogs

Answer 15

Did not increase above cardiac cut offs in healthy dogs receiving boluses of Norm-R, Hypertonic saline, or 6% tetrastarch 130/0.4
The Norm-R group remained above baseline longer

Question 16

JVECC 2019 How is lactime defined

Answer 16

time in hours til lactate was > 2 mmol/L

Question 17

JVECC 2019 What was noted in survivors vs non survivors evaluating lactate and shock index

Answer 17

Lactate clearance was higher in survivors at time 1 hr, 10 hrs, and 24 hours overall
Survivors shorter Lactime

Question 18

JVECC 2019 Retro evaluation of K+ on prognosis in dogs and cats, what was found in prevelance and what increased mortality

Answer 18

Dogs, 27%, Cats 40 % abnormal K (up or down)

Increased mortality with Hypokalemia in dogs and hyperkalemia in cats
In dogs increased mortality compared to normal with mild hypo and hyperK
Urinary most likely to lead to hyperK
GI most likely to lead to hypoK

Question 19

JVECC 2019 What is the pulse wave transit time

Answer 19

time from ECG R-wave peak to rise point of the pulse oximeter wave of the same cardiac cycle
The rise point is 30% of peak amplitude
Inversely porptional to SV and has a strong negative correlation with SV

Question 20

JVECC 2019 What was the cut off for responders with pulse wave transit time

Answer 20

at a 3 ml/kg colloid bolus a -2.5% was a best fit cut off

There was a grey zone of -2.9 to -1.9

Question 21

JVECC 2019 In a retro review how did creatinine and Cl change in anesthetized dogs receving 6% HES 670/0.7

Answer 21

Low creatinine conctrations post than pre

Higher chloride concetnrations post than pre

Question 22

JVECC 2019 What are the systemic effects of hyper Cl-

Answer 22

altered renal blood flow, altered GFR, altered vascular resistance

Question 23

JVECC 2019 how did CT of thorax correltate with blood gas and acid base findings in dogs

Answer 23

No acid/base correlation

Trauma found on CT correlated with abnormal A-a gradient and PaO2

Question 24

JVECC 2019 How does hypoNa affect mortality

Answer 24

All causes higher mortality with hypo Na

Poor prognosis with CHF

Question 25

JVIM 2019 How is VitD metabolism altered with Ca Oxolate stones

Answer 25

Subset of patients had decreased conversion of 25 OHD to 24,25 (OH)2D (inactive form Vit D)