Fluids Flashcards
How much of total body weight is water?
70%
How many liters does intracellular fluid make up?
30 L, 2/3 total body water
How many liters does extracellular fluid make up?
15L, 1/3 total body water
How many liters does intravascular fluid make up?
5 L (3L plasma and 2 blood)
How many liters does extravascular fluid make up?
12 L (tissues adjacent to microvasculature) (the third space)
What does a positive tilt test indicate?
A 20% loss in fluid volume
What does hypotension in the supine position indicate?
A 30% deficit in blood volume
How do you calculate maintenance fluid requirements?
4-2-1:100-50-20 rule 4 ml/kg/h for the first 10 kg 2 ml/kg/h for the next 10 kg 1 ml/kg/hr for the other kg or 100 ml/kg/day for the first 10, 50 for next 10 and then 20 for every kg after
How do you calculate the deficit?
Multiply the maintenance fluid requirement by the hours of fasting
How fast do you infuse the deficit?
Over 3 hours. Half of fluid in first hour and the second half over 2 hours
What are the daily requirements of sodium?
2mmol/kg
What are the daily requirements for potassium?
1 mmol/kg
How many cc of crystalloid is equal to 1 cc of blood?
3 cc
How many cc of colloid is equal to 1 cc of blood?
1 cc
How many mL are lost for minimal trauma to the tissues?
4 ml/kg/hr
How many mL are lost for moderate tissue trauma without significant bowel exposure?
6 ml/kg/hr
How many mL are lost for severe tissue trauma?
8 ml/kg/hr
What are crystalloid solutions?
Usually contain glucose or saline
Good for replacement of insensible losses
What can crystalloid solutions cause?
edema in the interstitium due to decrease plasma oncotic pressure.
What can large quantities of NS result in?
Hyperchloremic metabolic acidosis
What can large quantities of LR result in?
Metabolic alkalosis due to increased production of bicarb from lactate
What are colloids?
Homogenous noncrystalline substances consisting of large molecules dissolved in solute.
What are the advantages of colloids?
Maintain intravascular space
What side effect has been reported with colloids?
Hypersensitivity reaction
Coagulation abnormalities
What are the coagulation abnormalities associated with colloid?
Dextran inhibits platelet aggregation and adhesiveness
Hydroxyethyl starch leads to a reduction in factor VIII and vWF
What are the types of colloids use today?
Albumin, Hydroxyethyl starch, dextran
What is albumin made from?
Human plasma that is pasteurized
What is hydroxyethylstarch made from?
amylopectin, kind of like glycogen
What’s the half life of albumin?
16 hours
What’s the half life of hydroxyethyl starch?
17 days
What is dextran made from?
Sucrose from the bacteria Leuconostoc mesenteroides.
What is Dextran 40 known for?
improving blood flow in the microvasculature due to decreased blood viscosity
