Fluid Therapy

Question 1

What are the 2 types of fluids?

Answer 1

1. Cyrstalloids
2. Colliods

Question 2

What are crystalloids

Answer 2

Solutions that are isotonic with plasma and contain sodium as the major osmotically active particle

Question 3

What are 3 isotonic crystolloid solutions? What are the 4 main uses for them?

Answer 3

1. Lactated Ringer’s Solution
2. 0.9% Sodium Chloride (Normal Saline)
3. Normosol-R

Uses:
1. Maintenance of normal hydration
2. Replacement of hydration deficits (including use during anesthesia)
3. Treatment of shock
4. Infusion of medications (such as potassium choloride; KCL)

Question 4

Why should KCL never be given to a patient via a fluid bolus?

Answer 4

• Can result in arrhythmias and even death when administered rapidly
• Rapid infusion of potassium can induce cardiac arrest

Question 5

What is the standard fulid maintance for a dog?

Answer 5

60mL/kg/dat

Question 6

Crystalloid anesthestic rate for dogs and cats

Answer 6

Dogs: 5mL/kg/hr
Cats: 3mL/kg/hr

Question 7

When treating shock what are the prefered isotonic crystalloids? What is the rate in dogs and cats?

Answer 7

Prefered fluids: LRS + Normosol-R
Dogs: 90mL/kg
Cats: 45mL/kg
Usually patients are give 1/4 their calculated fluids to start

Question 8

What are Dextrose Soultions? What are they used for?

Answer 8

Dextrose solutions are formed when dextrose is added to a crystalloid

Uses:
1. To provide free water to replace insensible losses or for correction of hypernatremia resulting from a water deficit.
2. To provide an intracellular carbohydrate source in septic patients and aids in correction of hypoglycemia

Question 9

When should Dextrose solutions not be used + why?

Answer 9

Maintence fluids as they wull lead to dilution of electrolytes

Question 10

What routes can Dextrose be given?
What occurs if they are given the incorrect route?

Answer 10

Given IV or IO. Must be given aseptic technique as they are ideal for bacterial growth

If given SQ, Dextrose causes electrolytes to move into these tissues, leading to a decrease in circulating blood volume and resulting in tissue necrosis

Question 11

What are synthetic colloids used for? Three main types + their fluid rates? What routes are acceptable

Answer 11

1. Act primarily to expand plasma volume
2. Useful as resuscitative or replacement fluids + can be given as a bolus if the patient has poor perfusion due to hypovolemia

Examples:
1. Hetastarch: 20mL/kg/day; Treatment of Hypotention: 5-10mL/kg boluses
2. Dextrans 40: 2mL/kg/hr
4. Dextrans 70: 2mL/kg/hr

Routes: IV or IO

Question 12

What are Colloids used to for? What are three examples? What routes are acceptable? Rate of infusion?

Answer 12

1. For the relative expansion of the interstitial space in the event of a plasma volume deficiency, resulting from traumatic or septic shock
2. Replacement of lost blood volume

Examples: human/canine albumin, fresh frozen plasma, and whole blood

Routes: IV or IO

Rate of Infusion: depends on the clinincal status of patient and reason for transfusion

Question 13

Signs of dehydration?

Answer 13

5-6%: Dry or “sticky” orall mucous membranes (MM)

6% - 8%: Mild to moderate decrease in skin turgor, dry or “sticky” oral MM, sunken eyes

10% - 12%: Marked decrease in skin turgor, dry MM, sunken eyes, weak and rapid pulses, slow capillary refill time, moderate to marked mental depression