ELECTROLYTES AND FLUID RESUSCITATION

Question 1

what can be used to help detect hypovolemia?

Answer 1

ultrasound

• hyperdynamic myocardium (high EF)
• IVC size and collapse

Question 2

what are the four phases of fluid therapy?

Answer 2

resuscitation
-period of fluid responsiveness

optimization

• ischemia and reperfusion
• need for fluid may reflect illness severity

stabilization

• absence of shock
• fluid only to cover needs

evacuation
-patients develop global increased permeability

Question 3

ICF is what fraction of TBW?

Answer 3

2/3

Question 4

ECF is what fraction of TBW?

Answer 4

1/3

• 25% of plasma
• 75% is interstitial fluid

Question 5

electrolytes flow freely between ECF and ICF?

Answer 5

nope

Question 6

isotonic fluids?

Answer 6

0.9% NaCl, normal saline
lactated ringers solution (LR)
plasma-lyte

Question 7

hypotonic fluids?

Answer 7

5% dextrose in water (D5W)

5% dextrose in 0.45% NaClm (D5 1/2 NS)

Question 8

hypertonic fluids?

Answer 8

3% NaCl, (hypertonic saline)

Question 9

what should not be used for acute resuscitation?

Answer 9

D5 1/2 NS is often given for maintenance IVF

Question 10

what is used for volume resuscitations?

Answer 10

isotonic fluids

• lactated ringers
• normal saline
• plasma-lyte

Question 11

fluids for:

hyperchloremic metabolic acidosis, and renal failure

balanced solutions act to neutralize acidemia

Answer 11

NS

LR and plasmalyte

Question 12

this solution stays intravascular to a greater extent the isotonic crystalloids, but no outcome advantage has been shown?

Answer 12

colloid solutions