Fluid therapy Flashcards
What is an animals total body water?
~60% BW in an average adult; ~80% in new-born
What is the average blood volume of each species?
Dog: 90 mL/kg Cat: 65 mL/kg Equine: 70 mL/kg (100 mL/kg in TBs) Bovine: 60 mL/kg Ovine: 60 mL/kg Porcine: 50 mL/kg
What is the most important protein in oncotic pressure?
Albumin
What are indications for the use of balanced electrolyte solutions?
Need for rapid volume expansion; replacement of blood loss (3x the volume); initial phase of shock treatment
True/False: balanced electrolyte solutions should be given slowly and in small volumes.
False. Can be given fast and in large volumes.
What is a contraindication for the use of balanced electrolyte solutions?
Large amounts should not be given for hypo-albuminemic patients (dilutes plasma proteins)
What are maintenance solutions used for?
Tailored to replace daily fluid loss; contains less Na and more K than plasma
What is physiological saline used for?
Used for rapid ECF volume expansion if balanced solutions are not available; 0.9% NaCl
What can happen with excessive use of physiological saline?
Dilution of other EC electrolytes; hyper-chloremic metabolic acidosis
What is hypertonic saline?
7.5% NaCl
What are indications for the use of hypertonic saline?
Need for quick IV volume expansion; severe shock (initial phase); head injury with elevated ICP
What are contraindications for the use of hypertonic saline?
Uncontrolled hemorrhage; dehydration; cardiac dysrhythmias
True/False: dextrose (glucose) solutions are a good source of free water.
True
True/False: dextrose solutions are generally an appropriate solution for peri-operative use.
False
What are colloids?
Large molecules that stay intravascular; increase plasma oncotic pressure and vascular volume
When should colloids be considered?
When plasma albumin is low, or is expected to become low
What are some general issues with colloids?
Volume overloading; allergic reaction; possible effect on hemostasis
What are the different types of colloids?
Hydroxy-ethyl starch (HES), dextran, gelatin, albumin (5%), plasma, whole blood
What are the common types of HES?
Hetastarch, Vetstarch
How is HES metabolized and eliminated?
Metabolized by serum amylase and eliminated by kidney or RES
Which of the following is a reason to give IV fluids during anesthesia?
Maintain patient IV catheter Compensate for drug induced vasodilation Compensate for dehydration (fasting) Increase preload therefore CO Replace ongoing fluid losses
All of the above
What is the rate of crystalloid fluid for maintenance during anesthesia?
10 mL/kg/h
In the case of hypotension, what is the rate of fluid therapy?
10 mL/kg bolus (within 15 min)
How do you replace blood loss immediately with crystalloids and colloids?
Crystalloids: 3x volume of lost blood
Colloids: exact volume of lost blood
When should you consider a whole blood infusion?
If > 20% of total blood volume is lost
