Lecture 13 & 14: Fluid Therapy 1 (Exam 2) Flashcards by Shelby Rainbolt

What is one thing that is extremely important about fluid therapy

It needs to be individualized

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What is the importance of learning fluid therapy

Common practice in vet me
Standard of care during the perioperative period

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Why can fluid therapy be risky

Can create a fluid overload

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What is crystaloid fluid

Salt in water

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What is colloids

Other stuff in water (like starch made from corn)

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What is the difference between colloids & crystalloid

Colloids are bigger molecules

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How many L of fluid can a horse take into to its vascular system

2 to 3 L

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What is the way to monitor fluid therapy

Is the px fluid responsive

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What is a symptom of fluid overload

Pulmonary edema
Having > 10% increase Bwt. when given fluids
Increased in gut sounds

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What is the body weight (ml/kg) of blood volume in dogs, cats, horses, & cows

Dogs - 80
Cats - 60
Horses - 70
Cow - 55

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What % of body wght is total body water in the body

69%

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How much of the total body water is intracellular fluid

40%

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What % of the total body water is extracellular fluid

20%

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What % of the extracellular fluid is interstitial fluid

15%

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What percent of the extracellular fluid is plasma

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Is the arteriole or pulmonary interstitium more alveolar

The pulmonary

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What are the two big compnents that

Size of the molecule
Hydrostatic pressure

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Describe the interstitium

Is like a slinky (to get it to stretch we need to add some force)
If we stretch it to far it will stay stretched
Fluid begins to accumlate in the interstitium until we stop & it will be released & urinated out
A dynamic space/reservoir

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What is the pressure found in the interstitium

A neg pressure

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What should the interstitium pressure never go over

+ 10 cm of water

What is the rapid exchange of fluid in the interstitium

The pressure is around - 5 cm
Perfect amount of pressure in the interstitium in that organ

When does slow exchange occur

Overstretched the interstitium
Takes longer
Occurs after the rapid exchange of fluids

Why give fluids

maintain hydration
Treat/prevent dehydration
Treat/prevent hypovolemia
Treat hypotension (Mean arterial BP)
Normalize Acid-base balance
Normalize electrolytes
Supply calories
Provide access to a vein

T/F: Dehydration should be treated rapidly

False; needs to be treated slowly so that you don’t overload the cells

When is dehydration considered a big deal

When the animal has lost ~ 5% of the their BW in fluid

What can cause hypotension

* Drugs (anesthesia) * Hypothermia * Hypercarbia (CO2) * Acidemia * Hyperkalemia * Heart failure or arrhythmia * Sepsis

Why does hypotension occur during anesthesia

* Wipe out autonomic reflexes * More blood is moving from the arteries to the veins

Which part of the nervous system is most important when talking about fluid therapy

Sympathetic NS

T/F: Fluid will dilute anything that they do not contain

True

How much should animals be able to compensate for the loss of their blood volume

10 to 15%

What is the "turning point" where things start to go bad during blood loss

25 - 30%

What organs start to go if hemorrhage increases

* Kidneys go first * Stomach goes next

Describe colloid fluids

* Use to be really popular * All of them have the ability to cause an allergic reaction (can lead to renal compromise in humans) * If big can cause fluids to stay in the vascular system or bring fluid in from the plasma

Define Osmolarity

The number of solute particles per 1 L of solvent

Define Tonicity

* The ability for water to mine in or out of a cell by osmosis (effective osmoles) * Depends on the molecular weight & what they do when fluid moves

Define colloid osmotic pressure

* The osmotic pressure exerted by large soluble molecules referred to as oncotic pressure

Define a drug

A medicine or other substance which produces a physiological effect when introduced into the body

Define maintenance fluid therapy

Daily metabolic requirement

Define Replacement fluid therapy

Replace of lost fluids. Includes insensible losses like daily fluid loss from the respiratory system, skin, & water excreted in stool

Define resuscitative fluid therapy

Acute restoration of hemodynamics, tissue perfusion, & oxygen delivery

What do hemoglobin based oxygen carriers do

* Provide the same thing as fluids do * Provides oxygen carriers

What is the percent of Na+Cl in saline

0.9% (9000 mg/L)

What is the division of cardiac output to the body

* Vessel rich group = 75% * Muscle group = 18% * Vessel poor group = 2 % * Fat group = 5%

T/F: The smaller the amount of fluid the faster you can give the fluid

True

Which tissue contains less water than lean tissue

Fatty tissue

What is the third space

Where the fluids get trapped in a space where the fluids are not interchangeable and not perfusing throughout the px (for hours or days)

What are the biggest issues in fluid therapy

* What fluid? * What rate? ml/kg/h * What volume? ml/kg * When & how long?

What is a rule of thumb to remember on how much fluid to give a px

* 80 to 90 ml/kg/h will cause or be a factor of their death * 60 should be the highest dose