Week 2- Fluid Therapy Flashcards
What is the total blood volume of a dog/ horse?
8-9% of the body mass
What is the total blood volume of a cat/ cattle/ sheep?
6-7% of the body mass
What decides what makes fluid move between compartments?
- Tonicity of fluid
- Tonicity of extracellular compartment
- Size of the macromolecules in the fluid
- Movement across endothelial membranes
- Condition of the capillary membrane
- Hydrostati pressure, colloid osmotic pressure and vascular permeability
What are the four types of fluid loss?
- Water and Electrolytes
- Blood
- Protein rich ECF
- Pure water
What is the sensible fluid loss?
Urine output
What is an insensible fluid loss?
examples
- Faeces
- Respiration
- Saliva
- Cutaneous
- Respiratory tract
What is the function of goal directed fluid therapy?
Restore homeostasis- euvolemia and hydration
Correction of acid base and electrolytre imbalance
What is hypovolaemia?
Decreased fluid volume within the vascular space
* loss of tissue perfusion
* loss of blood and/ or fluid and electrolytes
* can affect other compartments if it persists
* rapid replacement therapy
What is dehydration?
Decreased fluid volume within the interstitial compartment
* can affect all other compartments also causing hypovolaemia
* water and electrolyte imbalance
* slower, sustained replacement
What would you notice on the physical examination for hypovolaemia?
- altered mentation
- tachycardia/ arrhythmia
- paler mucus membranes
- weak peripheral pulse
- cold extremities
- tachypnoea
What are the four types of fluids available?
- Crystalloids
- Colloids
- Oxygen- carrying solution
- Blood Products
What is Hartmann’s solution?
- Balanced solution
- Used for replacement/ resuscitation
- Alkalinisng solution
- Liver- lactate converted into glucose: 2 H+ consumed
- Oxidative metabolism: HCO3- production
What are hypertonic crystalloids used for?
Resuscitation and rapid intravascular volume expansion
* Draws water from the ICS, ISS and RBC
Why do you need to be careful with Hartmanns solution and blood clots?
Increased calcium
What are hypotonic crystalloids used for?
Miantenance fluids
* Good for pure water loss treatment
What are colloids?
Macro molecules suspended in a crystalloid solution
What are colloids good for?
Hypoproteinaemia
What are natural colloids?
Blood Products
What are synthetic colloids?
Dextrans and Hydroxyethyl starch
What are the adverse effects of colloids?
Coagulation impairment, acute kidney injury death
What three things are fluids helpful for?
- Resuscitation
- Replacement
- Maintenance
What is the treatment plan for dehydration?
Balanced isotonic crystalloids
What are the goals of fluid therapy during anaesthesia?
- O2 delivery and tissue perfusion
- Macro Circulation
- Micro Circulation
- Maintain/ Correct electrolyte composition and acid balance
What is infusion equipment?
- Intravenous cannula
- Intraosseous catheters
- Fluids of choice
- Giving set
- Fluid pump/ syringe driver
- Pressure bag
What do you monitor during fluid therapy?
Clinical signs- Heart rate, Arterial Pressure, Pulse rate and quality, Capillary refill time, Mentation, Skin turgor
What are the common adverse effects of fluid therapy?
- Fluid overload/ Intolerance
- Electrolytes and acid-base imbalance
- Diluton coagulopathy
