Fluid therapy

Question 1

What is an animals total body water?

Answer 1

~60% BW in an average adult; ~80% in new-born

Question 2

What is the average blood volume of each species?

Answer 2

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

Question 3

What is the most important protein in oncotic pressure?

Answer 3

Albumin

Question 4

What are indications for the use of balanced electrolyte solutions?

Answer 4

Need for rapid volume expansion; replacement of blood loss (3x the volume); initial phase of shock treatment

Question 5

True/False: balanced electrolyte solutions should be given slowly and in small volumes.

Answer 5

False. Can be given fast and in large volumes.

Question 6

What is a contraindication for the use of balanced electrolyte solutions?

Answer 6

Large amounts should not be given for hypo-albuminemic patients (dilutes plasma proteins)

Question 7

What are maintenance solutions used for?

Answer 7

Tailored to replace daily fluid loss; contains less Na and more K than plasma

Question 8

What is physiological saline used for?

Answer 8

Used for rapid ECF volume expansion if balanced solutions are not available; 0.9% NaCl

Question 9

What can happen with excessive use of physiological saline?

Answer 9

Dilution of other EC electrolytes; hyper-chloremic metabolic acidosis

Question 10

What is hypertonic saline?

Answer 10

7.5% NaCl

Question 11

What are indications for the use of hypertonic saline?

Answer 11

Need for quick IV volume expansion; severe shock (initial phase); head injury with elevated ICP

Question 12

What are contraindications for the use of hypertonic saline?

Answer 12

Uncontrolled hemorrhage; dehydration; cardiac dysrhythmias

Question 13

True/False: dextrose (glucose) solutions are a good source of free water.

Answer 13

True

Question 14

True/False: dextrose solutions are generally an appropriate solution for peri-operative use.

Answer 14

False

Question 15

What are colloids?

Answer 15

Large molecules that stay intravascular; increase plasma oncotic pressure and vascular volume

Question 16

When should colloids be considered?

Answer 16

When plasma albumin is low, or is expected to become low

Question 17

What are some general issues with colloids?

Answer 17

Volume overloading; allergic reaction; possible effect on hemostasis

Question 18

What are the different types of colloids?

Answer 18

Hydroxy-ethyl starch (HES), dextran, gelatin, albumin (5%), plasma, whole blood

Question 19

What are the common types of HES?

Answer 19

Hetastarch, Vetstarch

Question 20

How is HES metabolized and eliminated?

Answer 20

Metabolized by serum amylase and eliminated by kidney or RES

Question 21

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

Answer 21

All of the above

Question 22

What is the rate of crystalloid fluid for maintenance during anesthesia?

Answer 22

10 mL/kg/h

Question 23

In the case of hypotension, what is the rate of fluid therapy?

Answer 23

10 mL/kg bolus (within 15 min)

Question 24

How do you replace blood loss immediately with crystalloids and colloids?

Answer 24

Crystalloids: 3x volume of lost blood
Colloids: exact volume of lost blood

Question 25

When should you consider a whole blood infusion?

Answer 25

If > 20% of total blood volume is lost