decision making in fluid therapy Flashcards
What is the primary method to assess fluid deficit in patients?
Physical examination
Assessment includes evaluating major body systems for hypovolaemia.
What clinical signs are associated with less than 5% dehydration?
• History of vomiting, diarrhoea or other fluid loss.
• No detectable abnormalities on examination.
At what percentage of dehydration do signs of hypovolaemia become evident?
7-10%
Signs include dry mucous membranes and increased skin tent.
What are the clinical signs of 12% dehydration?
• Dry mucous membranes, increased skin tent, sunken eyes.
• Decompensated shock: tachycardia, weak/absent pulses, hypotension, cold extremities, hypothermia.
What should be monitored in hospitalized patients to assess fluid status?
• Physical examination at least twice daily.
• Serial bodyweight.
How is ongoing fluid loss measured in patients?
By accounting for fluid losses such as polyuria, GI losses, or drain production
Exact measurement is ideal, but often guesstimation is used.
What is the best way to monitor urine output (UOP)?
Indwelling urinary catheter with a closed collection system
UOP should be recorded at least every 4 hours.
What is the urine output classification based on mL/kg/h?
• Polyuric: > 2 mL/kg/h
• Oliguric: < 1 mL/kg/h
• Anuric: 0 mL/kg/h.
What is the significance of blood work in hydration assessment?
It provides information on the patient’s perfusion/hydration status and flags electrolyte abnormalities.
What changes in blood work may indicate dehydration?
Haemoconcentration with an increase in PCV and TS (or TP)
However, conditions like anaemia or hypoproteinaemia can complicate interpretation.
What characterizes prerenal azotaemia?
• Evidence of dehydration or hypovolaemia
• Usually well-concentrated urine
• Rapid correction of azotaemia within 24-48 hours.
What does isosthenuria indicate in a hospitalized patient on fluids?
Usually indicates adequate hydration
In critical patients, further evaluation is necessary.
What is the role of intravenous fluids in patient care?
To treat acid-base and electrolyte abnormalities
May also cause imbalances.
What is the normal urine specific gravity (USG) for a dehydrated dog?
> 1.030
For cats, it is > 1.035.
How is central venous pressure (CVP) historically used in fluid therapy?
To estimate right atrial pressure and guide fluid therapy in critical patients.
What does an increase in the left atrium to aorta ratio (LA:Ao) suggest?
May indicate left-sided congestive heart failure or hypervolaemia.
How can the caudal vena cava (CVC) diameter be evaluated?
Via subxiphoid, intercostal, or sublumbar views
Dynamic measurements assess CVC collapsibility.
What do developing or worsening B lines indicate in pulmonary POCUS?
Excessive lung water buildup.
