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Body fluid composition

Water makes up 60% of weightIntracellular water--40% of weight, 2/3 of total body water, high K +Extra cellular water--20% of weight, 1/3 of total body water, high Na +EC water is1. Intravascular/plasma 25%2. Extravascular/interstitial 75%


Movement of fluid within the body depends on.....

... The balance btwn 1. Filtration (incr hydrostatic P, decr oncotic P)2. Resorption (decr hydrostatic P, incr oncotic P)occurs at the level of the capillary


Define dehydration

Hypohydration= loss of bodily fluidsCauses: GI, renal, burns/skin, respiratory tract, saliva, third spacing, hemorrhage


Dehydration and PE chart

<5% non-detectable5-8% decr skin turgor, dry MM8-10% + eyes sunken, prolong CRT10-12% + severe skin tent, eyes sunken, prolong CRT, dry MM, +/- shock12% life threatening


Shock dose dog vs cat

Dog 90ml/kgCat 50 ml/kg= to one blood volume


hyper vs hypotonic fluid losses

hypotonic fluid losses (loss of water >solutes)-->tonicity of extracellular fluid incr-->water shifts from intracellular to extracellular-->intracellular dehydrationhypertonic fluid losses (loss of solutes >water)-->tonicity of intracellular fluid will be higher or hypertonic and fluid to shift from extracellular to intracellular-->extracellular dehydration


guidelines for calculating rehydration for patient

KG x % dehyd (replacement) +estimated losses + maintanence


osmolarity of plasma

290-310 mOsm/L


isotonic fluids contain which types of bicarbonate precursors

alkalinizing effect1. lactate--metabolized by liver (D-lactate is not mx)2. acetate--metabolized by muscle (more profound effect)3. gluconate--metabolized by many cells


Fluid choice for patients with hypoNa, hypoCl, metabolic alkalosis

0.9% NaCl


T/FLarge quantities of acetate containing fluids can cause vasodilation and decr in BP

trueLarge quantities of acetate containing fluids can cause vasodilation and decr in BPsecondary to adenosine release (potent vasodilator) from muscle


fluid choice for head trauma patients

0.9% NaClbecause of high Na content (154 mEq/L) and is least likely to cause decr in osmolarity and subsequent water movement into brain interstitium


replacement vs maintenance fluids

replacement---isotonic (hi NaCl)maintenance--hypotonic (low NaCl, hi K)


option to treat free water deficit

hypotonic fluid252 mOsm/L (slightly lower than plasma)5% dextrose with sterile water


fluid choice for patients with diabetes insipidus or hypernatremia

sterile water with 5% dextrose


T/FD5W can be given as a bolus

FALSEhypotonicif given as a bolus will distribute to all body fluid compartments, cause acute decreases in osmolarity and lead to cerebral edema.


Why administer hypertonic fluids slowly

if hypertonic fluids are given too fast (> 1 ml/kg/min) osmotic stimulation of pulmonary C fibers results in vagal mediated bradycardia, bronchoconstriction, hypotensionbc monocyte dehydration and subsequent friction btwn monocytes


goal of hypertonic saline solutions

draw extravascular water into the intravascular spaceosmotic diuresis


contraindications of HTS use

do not given in already dehydrated animalsphlebitis/hemolysisavoid right atrium (leads to arrhythmias)


How are synthetic colloids described

by their weight average (Mw) or number average (Mn) molecular weightpolydispersity index Mw/Mn ratiohigher molecular weight molecules are not metabolized or excreted as quickly as smaller particlespersist longer


side effects of colloid administration

disrupt normal coagulationdecr factor VIII, vWFimpair platelet fxinterfer w fibrin clot stability-->increased finbrinolysis


hydroxyethyl starch colloids are characterized by what?

contain highly branched starch, amylopectinweight average (Mw)--low, med, hiconcentration %# substitutions (more substitutions last longer)


T/F Total protein refractometer readings are a valid way of monitoring colloidal therapy

FALSEcolloids do NOT increase TP


Characteristics of oxyglobin

Hb based oxygen carrying fluidsterile, ultrapure, bovine Hb solutionnonantigenic40 mm Hg oncotic P13 ml/dL Hb concentration


Side effect of oxyglobin administration

NO scavenging affectsvasoconstriction


How much blood can most animals lose prior to blood transfusion

most can lose 10-15%acute hemorrhage > 20% often requires blood transfusion


dose of pRBC, FFP, or whole blood

pRBC 10-15 ml/kgFFP 10-15 ml/kgwhole blood 20-25 ml/kg


blood volume in dog vs cat

90 ml/kg dog50 ml/kg cat


calculation of volume of pRBC to be deliveredShort et al JVECCS 2012

volume of RBC to be delivered = blood volume x kg x (PCV goal-PCV current)/PCV donor blood1.5 x %PCV rise x kg (both gave accurate predictions in PCV post pRBC transfusion)


What does whole blood contain

clotting factors (no longer present if stored >24hr)plateletsRBCplasmause within 8 hr