Terms, definitions and nomenclature of fluid administration 2021 seminal Flashcards
Absolute Hypovolemia
Reduction in total circulating volumee. Can be caused by dehydration, or the loss of blood
Acid
substance capable of increasing the concentration of hydrogen ions when dissolved in water (aqueous solution)
Acidosis
A process in which there is a net accumulation of acid in the body
acidemia
blood pH in which there is a net accumulation of acid in the body
Acute normovolemic hemodilution
blood conservation strategy where a specific volume of whole blood is removed from the patient and stored, and replaced by crystalloid or colloid solutions to restore volume prior to surgery. The rationale is to reduce the loss of RBC from surgical bleeding. The blood is given back after surgery.
Albumin
circulating blood protein weighing 69 kDa, synthetised by the liver and is the major determinant of plasma oncotic pressure
Alkalemia
blood pH that is the above the normal physiologic range for the species in questions
Alkalosis
A process in which there is a net accumulation of alkali in the body
Anion
negatively charged atom or molecule, such as chloride (Cl-) and bicarbonate
Anion gap
Calculated difference between the principle cations and anions in plasma. Formula:
AG= (Na + K) - (Cl + HCO) Anion gap is useful to narrow down the causes of metabolic acidosis
Autotransfusion
blood conservation strategy used during hemorrhage or surgery where shed blood is collected, typically mixed with anticoagulant, filtered and reinfused to the patient. If there is a RBC wash prior to readministration is called cell salvage
Balanced component resuscitation = balanced resuscitation
fluid resuscitation strategy in severe trauma management where blood products are transfused in proportions similar to blood (1:1:1 for RBC, PLT and Plasma)
Balanced crystalloid solution (= Balanced isotonic electrolyte solution, polyonic crystalloid solution or balanced salt solution)
FLuid that contains and electrolyte composition (particularly Na, K and Cl ) similar to found in plasma. It should maintain or normalize acid base balance and be isotonic and isosmotic with normal plasma
Base
substance that is capable of accepting a hydrogen ion when dissolved in water
Base deficit
amount of a strong base that must be added in vitro to 1 L of oxygenated blood to return the pH to 7.4 at a partial pressure of CO2 of 40mmHg and temp of 37C in presence of metabolic acidosis.
* represents a deficiency of base, or the negative form of base excess, where a BD of +1 mmol/L is equivalent to a BE of -1mmol/L
Base excess
the amount of strong acid that must be added in vitro to 1 L of oxygenated blood to return the pH to 7.40
Blood volume
total volume of blood contained within the circulatory system
Same as: vascular volume or intravascular volume
buffered crystalloid solution
intravenous fluid containing an acid-base buffer in order to help maintain or restore physiologic pH. This consist of an aqueous solution containing a mixture of electrolytes and weak acid and its conjugate base. The most common buffers are bicarbonate or organic anions ( e.g.
Cation
Positively charged atom or molecule
Central venous pressure
- Measurement of venous blood pressure within a large central vein, or more specifically, the cranial or caudal vena cava.
- It is a controversial method of assessing right ventricular preload: its not correlated with total blood volume.
Colligative properties
Alterations in the properties of a solvent due to the addition of solutes.
* Depend on the concentration of molecules in solution, rather than the type of chemical species present.
*E.g. Vapor pressure, boiling point, freezing point, osmotic pressure
Colloid
Large molecular weight molecule (>30 kDa) that are preferentially retained in the intravascular space following intravenous administration.
* Natural colloids: plasma and albumin
* synthetic Hydroxyethyl starches, dextrans and gelatins
Colloid osmotic pressure
Osmotic force generated by large molecules (colloids) in solution when separated by a semipermeable membrane from a region with a different colloid concentration.
* Same as oncotic pressure
Colloid solution
Intravenous fluid containing macromolecules dispersed in a crystalloid solution. It is administered to support intravascular volume or raise plasma colloid osmotic pressure.
* colloid fluid therapy is also called biophysical therapy.
Constant rate infusion (CRI)
continuous intravenous administration of a medication in order to maintain a steady delivery or plasma concentration
Critical hematocrit
minimum hematocrit that supports adequate tissue oxygenation and below which organ hypoxemia will develop
Crystalloid
Solution that contains electrolytes and other small water soluble molecules and/or dextrose.
* Organized by tonicity: hypotonic, isotonic and hypertonic
Cumulative fluid balance (vs Daily fluid balance)
Difference between all fluid inputs and outputs over a defined period of time. (over 24h is referred to as daily fluid balance)
Damage control resuscitation
Resuscitation strategy used to treat severely traumatized patients in order to reduce the development of the “lethal triad” of hypothermia, acidosis and coagulopathy. Key principles are the early use of blood products, avoidance of excessive crystalloid infusions which can cause dilutional coagulopathy, and permissive hypotension
Deescalation
Reduction of fluid administration due to clinical improvement of the patient
Dehydration
Loss of body water, with or without salt , at a rate greater than the body can replace it
Deresuscitation
Correcting fluid overload by using dialysis or diuretics to remove excess fluid
Early goal-directed therapy
Protocol- driven treatment algorithm that aims to guide fluid, vasoppressor and other resuscitation therapy toward specific hemodynamic end-points, with the goal of optimizing oxygen delivery.
Edema
Clinical manifestation of fluid accumulation within the interstitial tissue space (interstitial edema) or within cells (cellular edema)
Effective osmole
Electrolyte (ion) that exerts an osmotic force (i.e. pull) across a semi-permeable membrane. Effective osmoles determine a solution’s tonicity. Sodium ion is the predominant effective osmole in the body.
Electrolyte
Dissolved ions in solution that carry a positive or negative electric charge (sodium, K, Cl, Ca)