Lecture 13: Fluid Therapy 1 (Exam 2) Flashcards
What is one thing that is extremely important about fluid therapy
It needs to be individualized
What is the importance of learning fluid therapy
- Common practice in vet me
- Standard of care during the perioperative period
Why can fluid therapy be risky
Can create a fluid overload
What is crystaloid fluid
Salt in water
What is colloids
Other stuff in water (like starch made from corn)
What is the difference between colloids & crystalloid
Colloids are bigger molecules
How many L of fluid can a horse take into to its vascular system
2 to 3 L
What is the way to monitor fluid therapy
Is the px fluid responsive
What is a symptom of fluid overload
- Pulmonary edema
- Having > 10% increase Bwt. when given fluids
- Increased in gut sounds
What is the body weight (ml/kg) of blood volume in dogs, cats, horses, & cows
- Dogs - 80
- Cats - 60
- Horses - 70
- Cow - 55
What % of body wght is total body water in the body
69%
How much of the total body water is intracellular fluid
40%
What % of the total body water is extracellular fluid
20%
What % of the extracellular fluid is interstitial fluid
15%
What percent of the extracellular fluid is plasma
5%
Is the arteriole or pulmonary interstitium more alveolar
The pulmonary
Slide 9
What are the two big compnents that
- Size of the molecule
- Hydrostatic pressure
Slide 10
What is the function of the endothelial glycocalyx
Slide 11
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
What is the pressure found in the interstitium
A neg pressure
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
Slide 25
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
What is hydronephrosis
Watch vid talked about this during slide 27
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
Slide 31 - 35
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
Slide 47
Describe CVP
slide 48
Slide 49/50
What measures fluid responsiveness
