Fluid Notes

Question 1

Maintenance fluids

Answer 1

40-60mL/kg/day in adults/// 80-120 mL/kg/day in foals

needs are affected by species, age, fasting vs fed, ambient temp

DECREASE by HALF if fasted

Question 2

Deficit of fluids is measured as….

Answer 2

estimated percent dehydrated x body weight (kg)= deficit in liters
ex: horse is 450kg x 0.05= 22.5L deficit

Question 3

Blood volume of horses is approx. ___% of BW

Answer 3

8%

Question 4

What are three unquantifiable losses in horses?

Answer 4

Unquantifiable- moisture lost in respiration, evaporation from losses/exudates (ex: burn wounds), feces

Quantifiable- urine, NG tube, body cavity effusions, blood loss

Question 5

Monitor your fluid therapy-

Answer 5

repeat PE, repeat PCV/TP, lactate, and/or USG, urinary frequency

Question 6

Blood volume expansion-

Answer 6

Isotonic crystalloids (maintenance fluids), colloids, hypertonic saline, 
whole blood

Question 7

What are used for main. fluids??

Answer 7

Isotonic crystalloids- LRS and plasmalyte are most commonly used

Distribute quickly into entire extracellular space
(Approx. 1/3 stays in vasculature), 10L bolus- about 3 L blood volume expansion

Question 8

What is the disadvantage of using maintenance fluids?

Answer 8

Takes a long time to get in, large volumes may increase bleeding in trauma p or cause intestinal edema in colic cases

Question 9

What is advantages of using main. fluids?

Answer 9

distributes to all spaces

Question 10

_____ are fluids that contain a molecule that can exert oncotic pressure and can be natural or synthetic

Answer 10

colloids

Question 11

Natural colloids vs. synthetic colloids-

Answer 11

Natural- plasma, albumin

Synthetic- Hetastarch, dextran

Question 12

Advantage vs. disadvantages of colloids-

Answer 12

disadvantages- coag. at high doses

advantages- lasting oncotic support, low volume= quick to infuse

Question 13

What fluids are short lived (0.5-3 hrs) and MUST be followed up with isotonic volume replacement?

Answer 13

Hypertonic saline

Question 14

What is the dose of hypertonic saline?

Answer 14

4mL/kg (2 L for most adult horses)

Question 15

KNOW LISTING OF ADVANTAGES OF ORAL FLUID TX

Answer 15

Hydrates intestinal contents, can complement or replace IV fluid tx, stimulates GI motility, decreased need for precise control of e’lytes as compared to IV administration, greatly cheaper

Question 16

Volume of adult horse stomach is __-___ L

Answer 16

8-10L

Question 17

Standard size of IV jugular catheter:

Answer 17

14 gauge

Question 18

Fetlock drop and/or hip hike will be seen on the unsound or sound limb?

Answer 18

Sound limb

Question 19

Why do we start with FL with regional anesthesia?

Answer 19

FL lameness often changes the flight pattern of the HL

Question 20

Carbocaine-

Answer 20

onset is 60-90 sec and duration is up to 2 hours, 3mL usually used per nerve to effectively eliminate sensation in 5-10 mins

Question 21

What is the largest nerve and requires 30 mins for full effect???

Answer 21

Tibial nerve

Question 22

How to calculate fluid deficit?

Answer 22

Estimate % dehydration x bw in kg= deficit in Liters

Question 23

example of how to calculate deficit:

Answer 23

450 kg horse that is 5% dehydrated

450kgx 0.05= 22.5 L deficit

Question 24

blood volume of a horse is about ___% of bw

can only draw like 1% of their blood in body weight

Answer 24

8%

Question 25

Subjective tools to estimate deficit are...

Answer 25

Hollow above the eyes, skin tent, mm/CRT, fecal consistency, urine color and frequency

Question 26

Objective tools to estimate deficits are....

Answer 26

PCV/TP, BUN and creatinine, Urine specific gravity and lactate, HR

Question 27

What is blood volume expansion used for? What are the fluids that do this?

Answer 27

Maintaining perfusion to vital organs and stabilize the p so they will survive anesthesia; Isotonic crystalloids, colloids, hypertonic saline

Question 28

what is the volume expansion of giving 20 L of LRS? Approx 1/3 stays in vasculature so 10L bolus means 3 L for volume expansion

Answer 28

6-7 L

Question 29

For isotonic crystalloids (LRS, 0.9% saline, 5% dextrose, plasmalyte) stay in the vasculature aka are available for volume expansion?

Answer 29

1/3

Question 30

3 L of LRS means how much volume expansion? 2 L of hypertonic saline means how much L volume expansion (know that hypertonic saline is 8x tonicity of plasma and pulls fluids from interstitum to vasculature)

Answer 30

3L= 1L volume expansion 2 L= 8 L of volume expansion

Question 31

1 L of colloids= ___ liters of volume expansion

Answer 31

2 Liters

Question 32

1 Liter of hypertonic saline= ____ L volume expansion

Answer 32

4 L volume expansion

Question 33

What are the 3 common e'lyte supplementations in horses???

Answer 33

Potassium, calcium, magnesium

Question 34

Do not exceed ? of Potassium-- very important in small patients, regardless of species

Answer 34

0.5 meq/kg/hr

Question 35

Getting IV fluids in faster

Answer 35

Larger jugular catheter Multiple catheters Usually two jugular catheters; cephalic and lateral thoracic also an option Larger bore, shorter tubing Extension set and administration set-The smallest diameter tubing in the system decides the rate! Raise the fluids up higher to take advantage of gravity

Question 36

Oral fluid therapy advantages-

Answer 36

Hydrate intestinal contents - treat impactions Can complement or replace IV fluid therapy Stimulate GI motility – gastrocolic reflex Decreased need for precise control of electrolytes compared to IV administration Greatly decreased cost

Question 37

Hypertonic Saline

Answer 37

Approx 8 times the tonicity of plasma-- pulls fluid by osmosis from interstitium into the vasculature- short lived- 0.5-3 hours Must follow up with isotonic volume replacement Dose 4 ml/kg (2 liters for most adult horses) 1 liter = 4 liters of blood volume expansion

Question 38

Dose of hypertonic saline

Answer 38

Dose 4 ml/kg (2 liters for most adult horses) | 1 liter = 4 liters of blood volume expansion

Question 39

Advantages and disadvantages of hypertonic saline

Answer 39

Adv – cheap, low volume, improved microvascular perfusion | Disadv – cannot use if hypernatremic or hyperchloremic, short-lived effect 0.5-3 hrs