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RUSVM Anesthesiology 2016 > Fluid Therapy > Flashcards

Fluid Therapy Flashcards

1
Q

What are the roles of water?

A

Solvent for reactions
Transportation of substances Heat Regulation
Essential for organ function

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2
Q

What is the total Body water of the average adult?

A

60% of body weight

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3
Q

What is the total body water of a new born?

A

80% body weight

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4
Q

How much water is Intracellular fluid?

A

40%

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5
Q

How much water is extracellular fluid?

A

20%

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6
Q

How much water is intravascular fluid?

A

5%

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7
Q

How much water is interstitial fluid?

A

15%

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8
Q

How much of the total body weight is Intracellular Fluid?

A

2/3 = 66%

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9
Q

How much of the extracellular fluid is interstitial fluid?

A

2/3 = 66%

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10
Q

Cell membrane permeability

A

Impermeable for ions

permeable for water

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11
Q

Vascular wall permeability

A

Impermeable for large molecules

Permeable for water and ions

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12
Q

What ion is most prevalent in intracellular fluid?

A

Potassium

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13
Q

What ion is most prevalent in the extracellular fluid?

A

Sodium

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14
Q

What protein is most prevalent in the intravascular fluid?

A

Albumin

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15
Q

Osmosis

A

the movement of water across semipermeable membrane owing to concentration gradient

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16
Q

Osmolality

A

the number of particles per kg of water

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17
Q

Osmotic pressure

A

the pressure required to prevent this water movement

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18
Q

What is the normal osmolality in the ECF and ICF?

A

300mOsm/kg

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19
Q

Isotonic

A

no change in RBC volume

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20
Q

Hypotonic

A

RBC volume increases

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21
Q

Hypertonic

A

RBC volume decreases

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22
Q

Oncotic pressure

A

a form of osmotic pressure exerted by proteins that tends to pull water into the vascular space

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23
Q

What is the most important protein for oncotic pressure?

A

Albumin

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24
Q

What is the physiological plasma oncotic pressure?

A

23 mmHg

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25
Where is albumin synthesized?
Liver
26
When does edema form?
less than 1.5 g/dL
27
Hydrostatic pressure
drives fluid outward of the vascular space
28
Which way does oncotic pressure drive fluid?
Inward
29
Crystalloid solutions
crystalline solids dissolved in water
30
Balanced electrolyte solutions
can be given in large volumes causes no change in plasma electrolytes replacement of blood loss Initial phase of shock treatment
31
What are balanced electrolyte solutions used for?
Replacement of blood loss | Initial phase of shock treatment
32
What patients should balanced electrolytes solutions not be given to?
Hypo-albuminemic patients
33
What are maintenance solutions used for?
Replace daily fluid loss
34
When are maintenance solutions not used?
peri-operative use
35
What ion do maintenance solutions contain more of?
Potassium
36
What is physiological saline used for?
rapid ECF volume expansion
37
What does excessive physiological saline use lead to?
Dilution of other EC electrolytes | Hyper chloremic metabolic acidosis
38
What is Hypertonic saline used for?
Enhance cardiac function quick IV volume expansion severe shock head injury with elevated ICP
39
When is Hypertonic saline contraindicated?
Uncontrolled hemorrhage Dehydration Cardiac dysrrhythmias
40
What are colloids used for?
Increase plasma oncotic pressure and vascular volume
41
When do you use colloids?
Albumin is low or expected to become low
42
What are the issues with colloids?
Volume overloading allergic reaction Effect on hemostasis
43
Types of Colloids
``` Hydroxy-ethyl starch (HES) Dextran Gelatin Albumin Plasma Whole blood ```
44
What is the problem with Gelatin?
causes allergic reactions
45
HES
Chemically altered starch
46
What are the common HES?
Hetastarch | Vetstarch
47
What does HES do?
alters hemostasis and sick animals with von Willebrand disease
48
When are HES recommended?
first line of treatment of shock
49
What are the routes of administration for crystalloid solutions?
IV IO SC IP
50
What are the types of water losses?
Physiological Pathological Anesthesia
51
Where is water lost physiologically?
Renal GI Respiration Sweat
52
Where is water lost pathologically?
Vomiting Diarrhea polyuria bleeding
53
Where is water lost during anesthesia?
Open body cavities Respiration Drug induced polyuria
54
Reasons to give IV fluids druing anesthesia
``` Maintain patient IV catheter Compensate for drug induced vasodilation compensate for dehydration increased preload therefore CO Replace ongoing fluid losses ```
55
What is the amount of crystalloid for maintenance?
10mL/kg/hr
56
What is the amount of fluid therapy for youngsters or long procedures?
5mL/kg/hr
57
What is the amount of fluid therapy for patients with heart failure, anuric, renal failure or pulmonary edema?
1-2mL/kg/hr
58
What is the amount of fluid therapy if polyuria is present?
20mL/kg/hr
59
What is the amount of colloid solution for fluid therapy?
2mL/kg/hr
60
How much of fluid therapy should be given in case of hypotension?
10mL/kg bolus
61
How much crystalloid is used to replace blood loss immediately?
3 times the volume of blood lost
62
How much colloid is used to replace blood loss immediately?
exact volume of blood

RUSVM Anesthesiology 2016 (38 decks)

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