Fluid and Electrolyte Therapy During Anesthesia Flashcards
water moves between compartments via ________ and _______
- osmosis
- starling forces
3 benefits to low volume resuscitation (as for hemorrhagic shock)
- prevent dilution of RBCs and clotting factors
- avoids large increases in blood pressure
- improves patient outcome
clinical signs of hypovolemia
- tachycardia
- hypotension
- weak pulses
- prolonged CRT
- cool extremities
3 sources of ongoing fluid losses
- surgical hemorrhage
- diuresis
- GI losses
4 main electrolytes of the intracellular fluid compartment
- Mg
- K
- proteins
- organic phosphates
2 methods of estimating blood loss intra-op
- weighing sponges
- volume in suction cannisters
2 IV cath sites in the dog
- cephalic/accessory cephalic vein
- lateral saphenous vein
4 reasons for continuous IV access
- provide fluid therapy
- administer drugs
- transfusion therapy
- anesthetic monitoring
4 benefits/characteristics of fresh frozen plasma in fluid therapy
- colloid
- volume expansion
- oncotic support
- clotting factors
3 fluid compartments of the body
- intracellular fluids
- intravascular fluid compartment
- interstitial fluids
4 co-morbidities affecting fluid administration
- cardiac
- renal
- GI
- liver disease
PE findings for 10% dehydrated
Considerable loss of skin turgor,
severely sunken eyes, very dry mm,
obtunded, ↑ HR, ↓ BP
clinical signs of dehydration
- loss of skin turgor dry mucous membranes - sunken eyes - severe weak pulses - tachycardia - hypotension - obtunded
clinical signs of dehydration and hypothermia (6)
- skin tenting
- dry mm
- prolonged CRT
- increase HR
- cool extremities
- poor pulses
water moves between compartments via ________ and _______
- osmosis
- starling forces
________ loss of whole body water
dehydration
________ is the gold standard for anesthesia monitoring in horses
arterial catheterization
What are the 2 problems of hemorrhagic shock
- hypovolemia
- loss of oxygen carrying capacity
3 main electrolytes of the intracellular fluid compartment
- Na
- Cl
- HCO3
Uses of arterial catheterization
- monitoring of continuous BP
- monitoring of respiratory gases
What is the fluid plan in the event of hemorrhagic shock?
- LRS: calculate shock dose and administer 1/4 to 1/3
- hypertonic saline: 2-4 mL/kg slowly over 5 minutes, repeat as needed
- hetastarch: 2-5 mL/kg bolus and repeat up to total dose of 20 mL/kg/day
Lab tests to show fluid status (4)
- PCV/TS
- lactate
- BUN & creatinine
- USG
3 places arterial catheters can be placed in the horse
- facial artery
- transverse facial artery
- dorsal metatarsal artery
6 possible surrogate markers of perfusion and cardiac output to guide fluid therapy
- HR
- BP
- Central Venous Pressure
- lactate
- Pulse Pressure Variation
- urine output
3 disadvantages of hetastarch
- volume overloading
- coagulopathies
- renal damage
Advantage of hetastarch
dwell within the IVF space
PE findings for 8% dehydrated
Moderate loss of skin turgor, dry mm,
thready pulses, sunken eyes, ↑ HR
2 benefits of whole blood and packed RBCs
- volume expansion
- increased oxygen carrying capacity
fluid maintenance rate for dog/horse
5 mL/kg/hr
________: loss of fluid from the vascular compartment
hypovolemia
possible complications of vascular access
- vessel trauma
- thrombophlebitis
- catheter site infection
extravasation of fluids into SQ tissue - air embolization
exsanguination - thrombosis
- hematoma
- catheter breakage
- osteomyelitis (esp. IO)
- loss of arterial blood flow to the distal limb
- inadvertent administration of medications through the catheter
2 uses of hetastarch
- rapid volume expansion
- oncotic support
3 steps to creating a fluid therapy plan (isotonic crystalloid fluid therapy)
- calculate fluid deficit
- add maintenance requirements
- add ongoing losses
3 potential complications of arterial catheterization
- hemorrhage/hematoma
- air embolism
- inadvertant injection of drugs
Which two bones should you use for an IO catheter in a bird? Which two should you not use?
- ulna/tibiotarsus
- humerus/femur
every 2 mL/kg of whole blood given will raise the patient’s PCV by ____%
1%
fluid maintenance rate for cat
3 mL/kg/hr
IV cath sites for a rabbit (4)
- marginal vein of the ear
- saphenous vein
- cephalic vein
- jugular vein
2 IV cath sites in the cat
- cephalic vein
- femoral vein
PE findings for 5% dehydrated
Minimal loss of skin turgor, dry mm,
normal eye position
