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Specialties > Anaesthetics- Use of IV fluids > Flashcards

Anaesthetics- Use of IV fluids Flashcards

1
Q

What percent of the body is total body water?

A

60%

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2
Q

What is total body water (TBW) divided into?

A
  • Intracellular fluid

* Extracellular fluid

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3
Q

How much of TBW does intracellular fluid make up?

A

40% body weight (28L)

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4
Q

How much of TBW does extracellular fluid make up?

A

20% body weight (14L)

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5
Q

What is extracellular fluid divided into

A
  • Interstitial fluid (11L)

* Plasma (3L)

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6
Q

What is interstitial fluid?

A

Fluid in the spaces between cells

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7
Q

What is transcellular fluid?

A

Fluid that fills the cavities in the body e.g. aqueous humour in the eye

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8
Q

What is osmosis?

A

water moves from a dilute solution to a concentrated solution across a semi-permeable membrane

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9
Q

What is the role of osmotic pressure?

A

Stop osmosis occurring, by applying pressure to the concentrated solution

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10
Q

What does more particles in solution mean?

A

Higher the rate of osmosis therefore the higher the osmotic pressure

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11
Q

What does hypertonicity cause?

A

Cellular dehydration

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12
Q

What does hypotonicity cause?

A

Cell swelling

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13
Q

What are the symptoms of tonicity changes?

A

Neurological

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14
Q

What neurological symptoms does swelling of cells cause?

A

Raised icp
Compromised cbf
Herniation

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15
Q

What neurological symptoms does Shrinkage of cells cause?

A

Ich venous sinuous thrombosis

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16
Q

What are crystalloids?

A

Aqueous liquids that are soluble in water

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17
Q

What are some examples of crystalloids?

A
  • 5% dextrose
  • 0.9% saline
  • Hartmann’s solution
18
Q

What are the advantages of crystalloids?

A
  • Cheap

* Non-allergenic

19
Q

What are some disadvantages of crystalloids?

A
  • Ecf expansion

* (oedema/increased vascular pressure)

20
Q

What are colloids?

A

Aqueous liquids in insoluble in water

21
Q

What are some examples of colloids?

A
  • Gelatins
  • Starches
  • Dextrans
  • Albumin
22
Q

What are the disadvantages of colloids?

A
  • Anaphylaxis
  • Coagulopathy
  • Renal failure
  • rheology
23
Q

What are sensible losses?

A

Things you can measure

24
Q

What are examples of sensible losses?

A

Urine

Faeces

25
Q

What are insensible losses?

A

Things you cant measure

26
Q

What is an example of an insensible loss?

A

Sweat

27
Q

What is the maximum maintenance fluid you should give someone?

A

!00ml/hr

28
Q

Why should you not give someone more than 100ml/hr of maintenance fluid?

A

Risk of hyponatraemia

29
Q

What do you need to subtract when giving someone maintenance fluid?

A

Other oral intake

30
Q

How is IV maintenance fluid administered?

A

ml/hr via volumetric pump

31
Q

How should you alter maintenance fluid in the elderly?

A

Reduce it

32
Q

Which patients should be started on maintenance fluid immediately?

A

Patients fasting for ≥ 6hours

33
Q

Before giving replacement fluid, what do you need to add up?

A

Losses in the last 24hrs e.g. bleeding, D & V, drain output, fistulae and give this volume back
Remember

34
Q

What is replacement fluid given in addition to?

A

Maintenance fluids

35
Q

What do you need to remember when giving replacement fluid?

A
  • Urine output is a poor guide to fluid requirements

* Oliguria does not always require fluid therapy

36
Q

What replacement fluid could you give?

A

• PlasmaLyte 148

37
Q

What fluid would you give for upper GI losses?

A

0.9% NaCl with KCl

38
Q

How is replacement fluid administered?

A

Gravity giving set or volumetric pump

39
Q

What is resuscitation fluid used for?

A

For severe dehydration, sepsis or haemorrhage leading to hypovolaemia & hypotension

40
Q

How much resuscitation fluid should you administer?

A

Give fluid challenge of 250-500ml over 5-15 mins and reassess

41
Q

What fluid would you give as resuscitation fluid?

A

PlasmaLyte 148/colloid/blood

Specialties (18 decks)

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