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RUSVM Anesthesiology 2016 > Fluid Therapy > Flashcards

Fluid Therapy Flashcards

1
Q

What are the roles of water?

A

Solvent for reactions
Transportation of substances Heat Regulation
Essential for organ function

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2
Q

What is the total Body water of the average adult?

A

60% of body weight

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3
Q

What is the total body water of a new born?

A

80% body weight

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4
Q

How much water is Intracellular fluid?

A

40%

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5
Q

How much water is extracellular fluid?

A

20%

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6
Q

How much water is intravascular fluid?

A

5%

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7
Q

How much water is interstitial fluid?

A

15%

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8
Q

How much of the total body weight is Intracellular Fluid?

A

2/3 = 66%

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9
Q

How much of the extracellular fluid is interstitial fluid?

A

2/3 = 66%

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10
Q

Cell membrane permeability

A

Impermeable for ions

permeable for water

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11
Q

Vascular wall permeability

A

Impermeable for large molecules

Permeable for water and ions

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12
Q

What ion is most prevalent in intracellular fluid?

A

Potassium

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13
Q

What ion is most prevalent in the extracellular fluid?

A

Sodium

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14
Q

What protein is most prevalent in the intravascular fluid?

A

Albumin

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15
Q

Osmosis

A

the movement of water across semipermeable membrane owing to concentration gradient

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16
Q

Osmolality

A

the number of particles per kg of water

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17
Q

Osmotic pressure

A

the pressure required to prevent this water movement

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18
Q

What is the normal osmolality in the ECF and ICF?

A

300mOsm/kg

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19
Q

Isotonic

A

no change in RBC volume

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20
Q

Hypotonic

A

RBC volume increases

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21
Q

Hypertonic

A

RBC volume decreases

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22
Q

Oncotic pressure

A

a form of osmotic pressure exerted by proteins that tends to pull water into the vascular space

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23
Q

What is the most important protein for oncotic pressure?

A

Albumin

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24
Q

What is the physiological plasma oncotic pressure?

A

23 mmHg

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25
Q

Where is albumin synthesized?

A

Liver

26
Q

When does edema form?

A

less than 1.5 g/dL

27
Q

Hydrostatic pressure

A

drives fluid outward of the vascular space

28
Q

Which way does oncotic pressure drive fluid?

A

Inward

29
Q

Crystalloid solutions

A

crystalline solids dissolved in water

30
Q

Balanced electrolyte solutions

A

can be given in large volumes
causes no change in plasma electrolytes
replacement of blood loss
Initial phase of shock treatment

31
Q

What are balanced electrolyte solutions used for?

A

Replacement of blood loss

Initial phase of shock treatment

32
Q

What patients should balanced electrolytes solutions not be given to?

A

Hypo-albuminemic patients

33
Q

What are maintenance solutions used for?

A

Replace daily fluid loss

34
Q

When are maintenance solutions not used?

A

peri-operative use

35
Q

What ion do maintenance solutions contain more of?

A

Potassium

36
Q

What is physiological saline used for?

A

rapid ECF volume expansion

37
Q

What does excessive physiological saline use lead to?

A

Dilution of other EC electrolytes

Hyper chloremic metabolic acidosis

38
Q

What is Hypertonic saline used for?

A

Enhance cardiac function
quick IV volume expansion
severe shock
head injury with elevated ICP

39
Q

When is Hypertonic saline contraindicated?

A

Uncontrolled hemorrhage
Dehydration
Cardiac dysrrhythmias

40
Q

What are colloids used for?

A

Increase plasma oncotic pressure and vascular volume

41
Q

When do you use colloids?

A

Albumin is low or expected to become low

42
Q

What are the issues with colloids?

A

Volume overloading
allergic reaction
Effect on hemostasis

43
Q

Types of Colloids

A 
Hydroxy-ethyl starch (HES)
Dextran 
Gelatin 
Albumin 
Plasma 
Whole blood
44
Q

What is the problem with Gelatin?

A

causes allergic reactions

45
Q

HES

A

Chemically altered starch

46
Q

What are the common HES?

A

Hetastarch

Vetstarch

47
Q

What does HES do?

A

alters hemostasis and sick animals with von Willebrand disease

48
Q

When are HES recommended?

A

first line of treatment of shock

49
Q

What are the routes of administration for crystalloid solutions?

A

IV
IO
SC
IP

50
Q

What are the types of water losses?

A

Physiological
Pathological
Anesthesia

51
Q

Where is water lost physiologically?

A

Renal
GI
Respiration
Sweat

52
Q

Where is water lost pathologically?

A

Vomiting
Diarrhea
polyuria
bleeding

53
Q

Where is water lost during anesthesia?

A

Open body cavities
Respiration
Drug induced polyuria

54
Q

Reasons to give IV fluids druing anesthesia

A 
Maintain patient IV catheter
Compensate for drug induced vasodilation 
compensate for dehydration 
increased preload therefore CO
Replace ongoing fluid losses
55
Q

What is the amount of crystalloid for maintenance?

A

10mL/kg/hr

56
Q

What is the amount of fluid therapy for youngsters or long procedures?

A

5mL/kg/hr

57
Q

What is the amount of fluid therapy for patients with heart failure, anuric, renal failure or pulmonary edema?

A

1-2mL/kg/hr

58
Q

What is the amount of fluid therapy if polyuria is present?

A

20mL/kg/hr

59
Q

What is the amount of colloid solution for fluid therapy?

A

2mL/kg/hr

60
Q

How much of fluid therapy should be given in case of hypotension?

A

10mL/kg bolus

61
Q

How much crystalloid is used to replace blood loss immediately?

A

3 times the volume of blood lost

62
Q

How much colloid is used to replace blood loss immediately?

A

exact volume of blood

RUSVM Anesthesiology 2016 (38 decks)

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