Fluid therapy

Question 1

Fluid therapy is

Answer 1

Giving fluids to a patient
Used to correct dehydration, acid-base balance, electrolyte disturbances, shock, hemorrhage, hypotension, used to maintain blood pressure during general anaesthetic; to eliminate toxins from the body…..and many more reasons

Question 2

When and why do we give animals fluid

Answer 2

To correct dehydration
To treat shock
In a hemorrhaging patient
To treat hypotension
To correct acid/base abnormalities
To correct electrolyte abnormalities
To aid in the elimination of toxins
To aid in maintaining BP during anaesthesia

Question 3

Per Os way to give fluids

Answer 3

Preferred
Largest volumes
Limitations
Mild dehydration
Slow absorption
The patient must be conscious
Not vomiting, no diarrhea (no GI pathology)

Question 4

Subcutaneous fluids

Answer 4

Under the skin
Works best in cats
Only a limited amount of fluids
Too large of volumes can cause pain and skin tearing
Only 100mL/day/CAT

Question 5

IV fluids

Answer 5

Sterile fluids delivered via an IV line and IV catheter
Fastest, largest volumes
Can give large volumes over a long period of time
Works in all conditions
High cost, must be hospitalized, technical
IV access
Only choice if severely dehydrated (>8%) or in shock
Preferred route in hypotensive

Question 6

What do you record when giving IV fluids

Answer 6

Time of placement, location and size of catheter
Type of fluid
Fluid rate
Start time and stop time
Total volume infused
Record of periodic checks
Sticker on bag if anything is added

Question 7

Saline fluids (crystalloids) types and are used for

Answer 7

Normal saline, 0.9% saline, 0.9% NaCl, physiological saline
Restoring hydration
Flushing tissues/body cavities
Very high levels of Cl- compared to plasma

Question 8

Balanced electrolyte solutions

Answer 8

Lots of different solutions available; each has a purpose
Normosol-M (used for maintenance) or 0.45% saline(with 13-20 mmol/L KCL added) are options for maintenance solutions
Normosol-R (used for replacement), LRS, and 0.9% NaCl (in some cases) are better options for replacement solutions
Solutions contain different concentration of Na+, K+, Cl-, bicarbonate, Ca2+ and dextrose (2.5%-5%)
Selection is based on what is best for restoring normal electrolyte balances in a particular patient

Question 9

Hypertonic saline

Answer 9

ONLY FOR EMERGENCY USE ON LARGE ANIMALS, IF THERE IN SHOCK
Specific use
Emergency use for pulling water into blood vessels or pulling water out of tissue spaces
Concentrated saline (2%, 3%,5%,7%, 23%) increased osmotic pressure in blood vessels→ pulls water out of interstitial space→ water enters vessels→ stays in vessels briefly

Question 10

Colloids

Answer 10

Used as an alternative to crystalloids when:
Crystalloids alone are not maintaining blood pressure
When it will be difficult to get enough crystalloids in fast enough to improve cardiovascular state
When there is a reduction in oncotic pressure (ex. Due to low albumin levels)
When a longer duration of effect is desired
Be very careful when used on animals in renal failure, Voluven is the best bet if a colloid is needed

Question 11

Types of blood products

Answer 11

Whole blood
Packed red blood level
Plasma
Fresh - frozen plasma- stored for <1 year
Frozen plasma- stored for 1-5 years
Platelet rich plasma
Platelet concentrate
Cryoprecipitate

Question 12

Replacement fluids are and stop when

Answer 12

Dehydrated
Deficient volume
(%dehydrated)x(kg)
Give 1st half faster; 2nd half slower
STOP WHEN ORIGINAL DEHYDRATION IS CORRECTED

Question 13

On going loses fluids are and are stoped when

Answer 13

Vomit
Diarrhea
Polyuria
Measure amount lost and replace it in a set time period
STOP IF NO VOMIT/DIARRHEA/POLYURIA

Question 14

Replacement volume calculation

Answer 14

deficit volume + ongoing losses

Question 16

What fluids would you use for maintenance

Answer 16

Normosol M or 0.45% saline with 13-20mmol/L KCl added

Question 17

What fluids would you use for replacement

Answer 17

Normosol-R, LRS, 0.9% saline