Surgical Recall Ch 17 Flashcards
What are the two major body fluid compartments?
Intracellular
Extracellular
What are the two subcompartments of extracellular fluid?
Interstitial (between cells)
Intravascular (plasma)
What percentage of body weight is fluid?
60%
What percentage of body fluid is intracellular?
66%
What percentage of body fluid is extracellular?
33%
What is the composition of body fluid?
60, 40, 20
60% of body weight is fluid
40% is intracellular
20% is extracellular
On average, blood accounts for what percentage of ideal body weight in adults?
~7%
How many liters of blood are in a 70-kg (154 lbs) man?
0.7 x 70 = 5 L
What is the physiologic response to hypovolemia?
Sodium/water retention via renin –> aldosterone
Water retention via ADH
Vasoconstriction via angiotensin II and sympathetics
Low urine output
Tachycardia (early) and hypotension (late)
What is third spacing?
Fluid accumulation in the interstitium (edema)
When does third-spacing occur postoperatively?
Third-spaced fluid tends to mobilize into the intravascular space around post-op day 3
What are the classic signs of third spacing?
Tachycardia
Decreased urine output
What is the treatment for third spacing?
IV hydration with isotonic fluids
What are the surgical causes of metabolic acidosis?
Loss of bicarb (diarrhea, ileus, fistula, high-output ileostomy, carbonic anhydrase inhibitors)
Increase in acids (lactic acidosis 2/2 ischemia, ketoacidosis, renal failure, necrotic tissue)
What are the surgical causes of hypochloremic alkalosis?
NGT suction
Loss of gastric HCl through vomiting or NGT