L11: Fluid Therapy (Shih)

Question 1

which more efficient at raising BP: colloids or crystalloids***

Answer 1

crystalloids

Question 2

colloids can cause clotting and have higher mortality rate in sick patients than crystalloids***

Answer 2

starch in colloids can cause inflammation, can get stuck in kidneys, etc.

Question 3

maintenance fluid rate for dogs

Answer 3

5 ml/kg/hr

Question 4

hypovolemia =

Answer 4

low BP

Question 5

how to treat catastrophic trauma with rapid exsanguination

Answer 5

aggressive large volume resuscitation

Question 6

how to treat severe trauma without head injury**

Answer 6

hypotensive resuscitation

-want to keep BP low or will keep bleeding

Question 7

how to tx severe trauma with head or lung injury**

Answer 7

small volume resuscitation with HTS or other hyperosmolar colloids
-want to keep BP higher because head and lungs need to be perfused

Question 8

higher the Na in fluids…

Answer 8

more fluid will go into vasculature

Question 9

reasons for free water loss resulting in hypernatremia

Answer 9

• dehydration
• v/d
• endocrine
• iatrogenic

Question 10

don’t rehydrate too quickly or endogenous proteins in brain will attract too much water and brain will swell –> seizure, death***

Answer 10

counteract with addition of mannitol to attract water back out of brain

Question 11

causes of hyponatremia

Answer 11

• loss of volume
• hypoadrenocorticism (Addison’s)
• iatrogenic (diuretics)

Question 12

complications of fixing hyponatremia

Answer 12

• animal get dehydrated, cells collapse and rip themselves out of myelin –> myelinolysis –> ataxia, paralysis, CNS (occurs days post tx)
• fix Na SLOWLY (10-20% per day), give replacement and maintenance fluids for hypotension