TxWes Guide CV/Fluid Volume

Question 1

Formula for MAP.

What is the normal adult range?

Answer 1

[SBP + (2xDBP) / 3]
or
[DBP + 1/3(SBP-DBP)]

Normal range: 70-105mmHg

Question 2

Normal CO

Answer 2

4-8 L/min

Question 3

Formula for CI

Normal range for CI?

Answer 3

(CO / BSA)

2.5 - 4 L/min

Question 4

Normal CVP range?

Answer 4

2-6 mmHg

Question 5

Normal PCWP?

What does PCWP measure?

Answer 5

8-12 mmHg

Helps measures LA pressure, along with L heart function (mitral valves & LV filling pressure).

Question 6

Normal PVR?
(pulmonary vascular resistance)

Answer 6

50 - 350 dynes/cm/sec⁻⁵

Question 7

Normal SVR?

Answer 7

700 - 1400 dynes/cm/sec⁻⁵

Question 8

Normal EF?

Answer 8

55-70%

Question 9

Normal mPAP? sPAP? dPAP?

Answer 9

mPAP: ~15mmHg
sPAP: 15-30 mmHg
dPAP: 5-15 mmHg

Question 10

Formula for Shock Index

Answer 10

(HR / SBP)

> 1 = increased M&M & chance of Mass Transfusion protocol (MTP)

Question 11

EBV of premature infant

Answer 11

95mL/kg

Question 12

EBV of full-term infant

Answer 12

85mL/kg

Question 13

EBV of infant - 12mo

Answer 13

80mL/kg

Question 14

EBV of male adult/child

Answer 14

75mL/kg

Question 15

EBV of female adult/child

Answer 15

65mL/kg

Question 16

EBV of morbid obese (BMI >40)

Answer 16

60mL/kg

Question 17

Allowable blood loss (ABL) formula

Answer 17

[(EBL x initial Hct) - (EBV x Hct allowable)] x3

Hct allowable = 30%

Question 18

Fluid Replacement Equivalent

Crystalloids

Answer 18

3ml / 1ml EBL

Question 19

Fluid Replacement Equivalent

Colloids

Answer 19

1ml / 1ml EBL

Question 20

Fluid Replacement Equivalent

Whole Blood

Answer 20

1ml / 1ml EBL

*same as colloids

Question 21

Fluid Replacement Equivalent

PRBC

Answer 21

0.5ml / 1ml EBL

PRBC Hct = 70%

Question 22

Fluid Replacement Equivalent

How much EBL is in a fully soaked 4x4 gauze? Raytech?

Answer 22

4x4 ≈ 10 mL
Raytech ≈ 20 mL

Question 23

Fluid Replacement Equivalent

How much EBL is in a fully soaked ‘lap’ sponge?

Answer 23

100-150cc

Question 24

What is the 4-2-1 rule for maintenance fluids?

Answer 24

1st 10kg = 4cc/kg/hr
2nd 10kg = 2cc/kg/hr
Every kg >20 = 1cc/kg/hr

Question 25

How do you accomodate for an NPO deficit with maintenance fluids?

Answer 25

(maintenance rate x #hrs NPO)

Question 26

What are the estimated evaporated losses?
(minimal, moderate, severe)

Answer 26

Minimal = 0 - 2 mL/kg/hr
Moderate = 2 - 4 mL/kg/hr
Severe = 4 - 8 mL/kg/hr

Question 27

Dose of ephedrine for HoTN?
Main receptor(s)?

Answer 27

5mg
⍺ & β agonist

[common] = 5mg/mL

Question 28

Dose of Neosynephrine for HoTN?
Main receptor(s)?

Answer 28

100mcg
⍺ agonist

[common] = 10mg/mL

Question 29

Labetalol dose for HTN?
Main receptor?

Answer 29

5mg
β (and ⍺) antagonist

[common] = 5m/mL

Question 30

Esmolol dose for HTN?
Main receptor?

Answer 30

10mg
β1 antagonist

[common] = 10mg/mL

Question 31

Hydralazine dose?
Main receptor?

Answer 31

5mg
Directly vasodilates on the smooth muscle of the arterioles.

[common] =20mg/mL