Fluid Therapy Flashcards
what are the types of body fluid?
Intracellular - fluid inside tissue cells
extracellular - fluid outside of cells
- intravascular = blood vessels
- interstitial = dense connective tissue and between cells
- transcellular = specialised fluid, GI secretions
why provide fluid therapy?
maintenance of fluid for patient unable to take oral fluids
- eg trauma to face/neck
- eg regurgitation/vomiting
to replace fluid losses and correct dehydration if the body can’t quickly enough
- e.g. from haemorrhage/diarrhoea/vomiting
to provide circulatory support
- eg. correcting shock/perfusion deficits
what does the body use fluid/water for?
chemical reactions - hydrolysis
transportation - blood
waste products
thermoregulation
lubrication - saliva
electrolyte balance
digestion
how is water taken in and lost?
taken in via:
- drinking
- eating - varies on dry vs wet
lost via:
- sensible loss - can be seen and measured - eg urine/blood/diarrhoea/vomit
- insensible loss - lost by evaporation - eg sweat/respiration
fluid loss is often increased via:
- vomit
- reflux
- diarrhoea
- heat
- blood loss
- shock
- malnutrition
- haemorrhage
types of fluid therapy?
isotonic
- electrolyte content same as blood
- most often used
hypertonic
- higher electrolyte content
- forces water out of cells due to osmotic pressure
- use in shock dosage then isotonic immediately
hypotonic
- lower electrolyte content
- forces water into cells due to osmotic pressure
- not often used - correct high electrolytes
clinical signs of varying hydration?
0-5%
- no specific signs
- maybe depressed and thirsty
- urine concentrated
5-7%
- sunken eyes
- dry MMs
- some tenting of skin
7-10%
- prolonged skin tenting
- hypovolemia symptoms (cold extremities/weak rapid pulse)
10-12%
- collapse and progressive shock
- organs begin to failure
12-15%
- severe shock
- death imminent
how to assess hydration?
PCV
- cats = 24-45%
- dogs = 37-55%
- rabbits = 36-48%
total protein
- dogs = 50-70g/l
- cats = 60-80g/l
urinalysis
- volume = 1-2ml/kg/hr
- colour and smell
specific gravity
- cats = 1.035-1.060ug
- dogs = 1.015-1.045ug
how do you calculate fluid rate?
maintenance fluid = maintenance x weight
÷ number of hours
÷ 60
x drip rate
how to calculate fluids with a deficit?
fluid deficit = %dehydration x weight x 10
total requirement = maintenance fluid + fluid deficit
÷ number of hours
÷ 60
x drip rate
how should you provide fluid therapy for blood loss/hypovolaemic shock?
Dogs: initial bolus of 10ml/kg-90ml/kg
Cats: initial bolus of 5ml/kg-50ml/kg
rate will depend on severity
continual monitoring is vital
reduce rate as soon as improvement
do not exceed 1 hour
ideal fluid rate for anaesthesia support?
dogs: 5ml/kg/hour
cats: 3ml/kg/hour
blood vs plasma administration?
blood
- contains RBCs, WBCs, platelets, clotting factors and plasma proteins
- used to aid oxygen delivery
plasma
- contains clotting factors and plasma proteins
in both cases, must monitor patient closely and not leave alone in-case of reaction
use, collection and storage of blood?
often used for:
- blood loss and hypovolaemia
- shock
- anaemia
- DIC
- clotting disorders
- thrombocytopenia
collection:
- into a prepared collection bag
- may contain either Acid Citrate Dextrose (ACD) or Citrate Phosphate Dextrose (CPD)
storage
- use within 6hrs - reduce inactivation of platelets and clotting factors and risk of bacterial growth
- ACD: 1-6 degrees for 21 days
- CPD: 1-6 degrees for 28 days
- packed RBCs: 1-6 degrees for 21 days
ideal administration rate of blood?
should not exceed 20% of total blood volume
administer slowly at 0.1ml/kg for first 10 minutes then proceed at correct rate
- dogs: 20ml/kg
- cats: 10-15ml/kg
- make sure to monitor PCV throughout
why should we test blood typing and cross-matching?
not necessarily required for a first/isolated blood transfusion
- not yet any antibodies to interrupt
- good for emergency use
testing is performed to avoid reactions
- identifies presence and absence of antigens and antibodies
- detects serological incompatibility
it is required for any recurrent transfusions and important for cats as a reaction is often fatal