Critical Care and IV Fluids Flashcards
What is type 1 respiratory failure?
Oxygenation failure
What is type 2 respiratory failure?
Oxygenation and ventilation failure
What is shock?
Acute circulatory failure with inadequate or inappropriately distributed tissue perfusion resulting in cellular hypoxia
What are the different kinds of shock?
Distributive (septic) Hypovolaemic Anaphylactic Neurogenic Cardiogenic
How do we calculate cardiac output?
HR x Stroke volume
What factors does stroke volume depend on?
Preload
Contractility
Afterload
What are some vasopressors sometimes used for CV failure?
Metaraminol
Noradrenaline
What are some useful ionotropes for CV failure?
Adrenaline
Dobutamine
What are crystalloids?
Aqueous solutions of mineral salts or other water-soluble molecules
What are colloids?
Colloids contain larger insoluble molecules, such as gelatin
Blood itself is a colloid
What are the different kinds of neurological failure?
Metabolic
Trauma
Infection
Stroke
What are some pros and cons to colloids over crystalloids?
Swifter volume expansion in the intravascular space
Cost more
May cause allergic reaction, blood clotting disorders and kidney failure
What are some pros and cons to crystalloids over colloids?
Cheap
Easy to use
Immediate fluid resuscitation
May cause oedema
What are some components of ECF?
ISF
Intravascular fluid
Water in connective tissue
Transcellular fluid
What is tonicity?
The ability of an extracellular solution to make water move into or out of a cell by osmosis
What is Hartog Jakob Hamburger?
0.9% saline same as human serum
“Normal saline”
No effect on red blood cells
What is a drawback of 0.9% NaCl?
1l NaCl 0.9% is 9g of salt
Can cause hyperchloraemic acidosis, < renal blood flow, < GFR which exacerbates sodium retention
What may acidosis affect apart from GFR and renal blood flow?
Cardiac contractility
What is maintenance fluid?
0.18% NaCl/4% glucose/0.3% KCl (40mmol/l KCl)
This fluid if given at the correct rate provides the daily requirements of water, Na, K and glucose to prevent starvation ketosis
Is urine output a good guide for fluid requirements?
No
Oliguria does not always require fluid therapy
What are some clinical measurements for body fluid?
OESOPHAGEAL DOPPLER
PULMONARY ARTERY CATHETER
IVC collapsibility
MINIMALLY INVASIVE CO MONITORS