Colloids Flashcards
Which types of colloids increase vascular volume more than the amount administered?
Synthetic colloids: Vetstarch and Hetastarch
How much does Hetastarch bring in from the interstitial space?
3.7% so 1 L would result in 1370 ml in the vascular space
What are indications for using colloids?
It improve intravascular volume: Hypovolemia, Hypotension
Also can be used to minimize edema with low oncotic pressure
What are the 3 things that determine HES half-life?
Molar substitution (HES subs - longer 1/2 life) C2:C6 substitutions (Higher = longer) Molecular Weight (> = longer)
If we use HES that is 10% vs 6% what is more likely to happen intravascularly?
Greater intravascular volume expansion
What does HES 450/0.7 mean?
450 - molecular weight
0.7 - molar subsitution
What clotting factors decrease in activity with use of hetastarch?
VII and vW factor (intrinsic pathway - affects aPTT)
Recommended dosage for Synth colloids in dogs
20 ml/kg/day
bolus: 5 ml/kg
Recommended dosage for synth colloids in cats
10-20 ml/kg/day
bolus 2.5 - 5 ml/kg
Which synthetic colloid is more likely to be used during surgery if blood volume needs to be maintained? Why?
VetStarch - minimal effects on coagulation
what is HES 130/0.4?
VetStarch, duration 4-6 hrs
Hetastarch is less likely to be used in general because of what other two side effects besides coagulopathies?
Hypersensitivities (Cats>Dogs)
Renal Failure
What is the difference between fresh frozen plasma and frozen plasma?
Fresh frozen - frozen within 8 hrs
Frozen - > 8 hrs (less clotting factors)
What does plasma contain?
Protein (albumin, globulin, fibrinogen)
Coagulation factors and AT
Immunoglobulins
Natural colloids will do what to intravascular volume?
increase it as much as is put in (1:1)
Indications for plasma transfusion?
DIC, low Vit. K, Clotting factor deficiency, Liver dz, immunodeficiency.
What is the best treatment for hypoalbuminemia?
Nutritional supplementation (e.g. NG tube)
What is the dosage for excessively elevated PT and PTT?
20 ml/kg - if not corrected, likely ongoing losses
What are the potential adverse effects of plasma transfusion?
Allergic reactions
Fluid overload
Infectious complications
When are Packed red blood cells indicated?
With severely anemic patients with normal coagulation status and protein status
How much will the PCV increase in a 30 Kg dog given 225ml (1 unit) of PRBCs?
1.5ml/kg so 1.5 x 30 = 45 ml
225/45 = 5%
When is Fresh or Stored Whole Blood indicated?
Anemia with hypoproteinemia and/or coagulopathy
How much will the PCV increase in a 5 Kg cat given 1 unit (60 ml) of whole blood?
2.2 x 5 kg = 11 ml 60/11 = 4.6%
