Peri-operative fluid management Flashcards
What are the volumes of extracellular and intravascular fluid in the body?
Intravascular is around 4L
Extracellular is around 14L
What are some clinical signs of reduced fluid balance?
Tachycardia Postural hypotension Decreased urinary output Decreased capillary refill Cool peripheries Dry mucous membranes Decreased skin turgor
What is normal urine output during a day?
1500mLs
What is a good urinary catheter output?
35-70mls/hr
What is 5 or 10% dextrose used for?
It is used for rehydration as it rapidly equilibrates across the bodies compartments
What is normal 0.9% saline used for?
Typically used in resusitation as it remains mostly extracellularly
When is hartmanns solution used?
Can be used for rehyrdation or resus but is often preffered to normal saline as it is more physiological
When are colloids typically used?
They have large molecular weight components so often have a longer intravascular half life so are used for resusitation. Have issues with anaphylaxis
When should red cells be trasfused and how much should you give?
They should be given in anaemia or haemorrhage. Aim to give them until haemoglobin reaches 90
How many units of platelets are in one bag?
4
What does fresh frozen plasma contain and when should it be given?
It contains clotting factors and fibrinogin. Should be given to aid clotting.
What is cryoprecipitate and when is it given?
It is concentrated plasma and is given in significant bleeding to keep fibrinogen up
What are the target levels of fibrinogin in major bleeding?
> 1.5g/L
