Week 9: Fluids Flashcards
body fluid
total body water=60%
intracellular 2/3 TBW
extracellular 1/3 TBW (intersititial fluid 3/4 of ECF, intravascular/plasma 1/4 of ECF)
plasma
5% of body weight
blood volume
8-9%-dogs and large animals
6-7& cats
calculating blood volume
dogs and large animals=90 ml/kg lean body weight
cats-60ml/kg lean body weight
electrolytes
cations: pos charge
anions=neg charge
colloids
large molecular weight
plasma protein
anions
chloride CL-
Bicarbonate HCO3-
Phosphates HPOr-
Proteins
cations
sodium NA+
Potassium K+
Magnesium MG 2+
Calcum CA2+
homeostasis
normal constant state
water solute movement
passive and active diffusion
Water permiability
across all membranes
concentration gradient
Electrolyte permeability
across vascular membrane not cellular
distributes throughout ECF
Colloid Permeability
fluid with large molecules
stay within the vasculature
water solute balance
pos and neg charge must be equal
solute provide osmotic pressure
small solutes pass freely intravascular space from interstitial space
IV fluids
1/3 fluids stay in intravascular space, 2/3 interstitial
Dehydration
depletes ECF
perioperative hemorrhage
loss of intravascular space
hypertonic saline or colloid
low albumin
blood plasma or colloid solution
IV
fast/versatile preferred
SQ
absorbed 6-8 hrs
isotonic
IO
fast alternative to IV
neonates
Crystalloids
electrolytes in water
hypotonic
isotonic
hypertonic
hypotonic
more water than electrolytes
5% dextrose,
0.45% NaCL, Normosol M, plasmalyte 56
isotonic
equal osmolaity
0.9% NaCL, Normosol R, Plasmalyte, 148 LRS
Hypertonic
electrolytes
3% and 7% NaCL
Colloids
high molecular weight
natural=plasma/albumin solution
synthetic=hetastarch, vetstartch, dextran 70
Surgery fluids
isotonic, polytonic, replacement fluids
sick patients
PCF less than 20
TP less than 3.5 g/dL
isotonic, polytonic replacement fluids
Crystalloids
Isotonic, polytonic, replacement
LRS, Normosol R, Plasma Lyte A and R, Isolyte S, ,
contains dextrose
resuscitation phase
restore vascular volume
reverse hypovolemic shock
replacement phase
correct dehydration
replace and maintain fluids
maintenance phase
after dehydration is corrected
hypotonic crystalloids
40-60 ml/kg/day
potassium chloroide
hypokalemia
dextrose
hypoglycemia
sodium bicarbonate
use with caution
metabolic acidosis
severe hyperkalemia
administration anesthesia and surgery
<10 ml/kg/hr during first hr
3-5 ml/kg/hr during rest of procedure
volume overload
pulmonary edema cavity effusion peripheral edema hemorrhage compromised patients (especially cats)
use slower infusion rate
overhydration
ocular nasal discharge chemosis subcutaneous edema increased lung sounds increased respiratory rate and dyspnea coughing and restlessness if awake hemodilution
Fresh whole blood
contains: RBC WBC platelets all coagulation factors proteins: albumin and globulin store for up to 8 hrs
stored whole blood
lose platlets
fewer coagulation factors
store up to 28 days refrigerated
packed red blood cells
whole blood spun down plasma removed:
RBC
WBC
why give pRBC
anemia
trauma
IMHA
cancer
plasma
all coagulation factors
protein: albumin, globulin
store plasma
liquid-refrigerated 14 days
fresh frozen-up to 1 year
frozen-up to 5 years (lose coagulation)
why give plasma
replace coagulation factors and/or proteins: rodenticide toxicity hemophilia DIC/heatstroke Von Wilebrand's Hypoproteinemia
DEA 1
dog erythrocyte antigen
positive or negative
DEA 4
most dogs have this antigen
universal donor dogs
DEA 4+= best
DEA 1 negative= universal
In house blood type testing
DEA
alveida
DMS Card Type
less expensive
results show agglutination
who gets what type
DEA -1 can donate to pos or negative
DEA 1+ can only donate to positive
Feline blood types
A=most common B=strong A antibodies AB rare no universal blood donor always type
crossmatch
if patient has transfusion before
if cannot type a cat
best practice any transfusion
pRBC transfusions
dogs
do not warm
gravity vest for dogs: syringe or fluid pump
use at least 22 gauge catheter
pRBC transfusion cats
syring pump preferable
use hemonate filter
administer within 4 hrs
fresh frozen plasma transfusion
slowly that
warm bath 30-37 degrees
