complications of fluid therapy Flashcards
What is fluid overload?
A serious complication of fluid therapy where the fluid delivered exceeds the patient’s physiological ability to handle it
Fluid overload can lead to interstitial/pulmonary oedema and effusions.
What can cause fluid overload?
Predisposing causes include:
* Underlying cardiac disease
* Pulmonary disease (e.g., pulmonary contusions)
* Oliguria
* Hypoproteinaemia
Fluid therapy must be used cautiously in patients with these conditions.
What are the clinical signs of fluid overload?
Signs may include:
* Harsh lung sounds/crackles
* Serous nasal discharge
* Chemosis
* Pitting oedema
* Jugular venous distension
* Increasing body weight
* In cats, new onset gallop rhythm
Assessment of the LA:Ao ratio and presence of B lines on POCUS may help.
How should fluid therapy be managed in suspected fluid overload?
Immediate actions include:
* Stop parenteral fluids
* Supplement oxygen if needed
* Consider diuretics like furosemide
* Relieve pleural effusion if necessary
Furosemide can help increase urine output in oliguric patients.
What is the prognosis for patients in anuric renal failure?
The prognosis is poor to grave
Options include treating underlying disease or referring for dialysis.
What is the risk of overaggressive fluid therapy in patients with uncontrolled haemorrhage?
It may exacerbate the haemorrhage due to increased arterial blood pressure and dilution of clotting factors
Limited volume resuscitation is recommended.
What is the goal of limited volume resuscitation?
To reach a mean arterial blood pressure of around 60 mmHg (systolic around 90 mmHg)
This is the minimum required to protect blood flow to vital organs.
What are common catheter complications?
Common complications include:
* Phlebitis
* Infection
* Extravasation of IV fluids
Careful catheter placement and maintenance can help avoid these issues.
How often should electrolytes be checked in patients on intravenous fluids?
Daily
The fluid plan should be reviewed as appropriate based on electrolyte levels.
True or False: Electrolyte disorders are uncommon in patients on intravenous fluids.
False
Electrolyte disorders are not uncommon in such patients.
