Colloids

Question 1

Which types of colloids increase vascular volume more than the amount administered?

Answer 1

Synthetic colloids: Vetstarch and Hetastarch

Question 2

How much does Hetastarch bring in from the interstitial space?

Answer 2

3.7% so 1 L would result in 1370 ml in the vascular space

Question 3

What are indications for using colloids?

Answer 3

It improve intravascular volume: Hypovolemia, Hypotension

Also can be used to minimize edema with low oncotic pressure

Question 4

What are the 3 things that determine HES half-life?

Answer 4

Molar substitution (HES subs - longer 1/2 life)
C2:C6 substitutions (Higher = longer)
Molecular Weight (> = longer)

Question 5

If we use HES that is 10% vs 6% what is more likely to happen intravascularly?

Answer 5

Greater intravascular volume expansion

Question 6

What does HES 450/0.7 mean?

Answer 6

450 - molecular weight

0.7 - molar subsitution

Question 7

What clotting factors decrease in activity with use of hetastarch?

Answer 7

VII and vW factor (intrinsic pathway - affects aPTT)

Question 8

Recommended dosage for Synth colloids in dogs

Answer 8

20 ml/kg/day

bolus: 5 ml/kg

Question 9

Recommended dosage for synth colloids in cats

Answer 9

10-20 ml/kg/day

bolus 2.5 - 5 ml/kg

Question 10

Which synthetic colloid is more likely to be used during surgery if blood volume needs to be maintained? Why?

Answer 10

VetStarch - minimal effects on coagulation

Question 11

what is HES 130/0.4?

Answer 11

VetStarch, duration 4-6 hrs

Question 12

Hetastarch is less likely to be used in general because of what other two side effects besides coagulopathies?

Answer 12

Hypersensitivities (Cats>Dogs)

Renal Failure

Question 13

What is the difference between fresh frozen plasma and frozen plasma?

Answer 13

Fresh frozen - frozen within 8 hrs

Frozen - > 8 hrs (less clotting factors)

Question 14

What does plasma contain?

Answer 14

Protein (albumin, globulin, fibrinogen)
Coagulation factors and AT
Immunoglobulins

Question 15

Natural colloids will do what to intravascular volume?

Answer 15

increase it as much as is put in (1:1)

Question 16

Indications for plasma transfusion?

Answer 16

DIC, low Vit. K, Clotting factor deficiency, Liver dz, immunodeficiency.

Question 17

What is the best treatment for hypoalbuminemia?

Answer 17

Nutritional supplementation (e.g. NG tube)

Question 18

What is the dosage for excessively elevated PT and PTT?

Answer 18

20 ml/kg - if not corrected, likely ongoing losses

Question 19

What are the potential adverse effects of plasma transfusion?

Answer 19

Allergic reactions
Fluid overload
Infectious complications

Question 20

When are Packed red blood cells indicated?

Answer 20

With severely anemic patients with normal coagulation status and protein status

Question 21

How much will the PCV increase in a 30 Kg dog given 225ml (1 unit) of PRBCs?

Answer 21

1.5ml/kg so 1.5 x 30 = 45 ml

225/45 = 5%

Question 22

When is Fresh or Stored Whole Blood indicated?

Answer 22

Anemia with hypoproteinemia and/or coagulopathy

Question 23

How much will the PCV increase in a 5 Kg cat given 1 unit (60 ml) of whole blood?

Answer 23

2.2 x 5 kg = 11 ml 60/11 = 4.6%