Fluid Therapy

Question 1

What are the roles of water in the body?

Answer 1

1. Solvent for reactions
2. Transportation of substances
3. Heat regulation
4. Essential for organ function

Question 2

What percentage of body weight is made up of water in adults?

Answer 2

60%

Question 3

What percentage of body weight is made up of water in neonates?

Answer 3

~80%

Question 4

Is % water higher or lower for obese animals?

Answer 4

Lower

Question 5

What percentage of water is in ICF?

Answer 5

40%

Question 6

What percentage of water is in ECF?

Answer 6

20%

Question 7

What percentage of water is in IVF?

Answer 7

5%

Question 8

What percentage of water is in ISF?

Answer 8

15%

Question 9

What is the blood volume per kg for dogs, cats, equine, bovine, ovine, and porcine?

Answer 9

Dogs 90mL/kg 
Cats 65mL/kg 
Equine 70mL/kg 
Bovine 60mL/kg
Ovine 60mL/kg 
Porcine 50mL/kg

Question 10

T/F: Cell membranes are permeable for water.

Answer 10

True- impermeable to ions

Question 11

T/F: Vascular walls are permeable for water and ions.

Answer 11

True- impermeable for large molecules

Question 12

What ion is in the highest concentration in ICF?

Answer 12

Potassium

Question 13

What ion is in the highest concentration in ECF?

Answer 13

Sodium

Question 14

What molecule is the highest concentration in IVF?

Answer 14

Albumin

Question 15

The movement of water across semipermeable membranes is called?

Answer 15

Osmosis

Question 16

What is osmolality?

Answer 16

Number of molecules per kg of water

Question 17

What is the pressure required to prevent water movement called?

Answer 17

Osmotic pressure

Question 18

What is the normal osmolality of ECF/ICF?

Answer 18

~300 mOsm/kg

Question 19

What effect will an isotonic solution have on RBCs?

Answer 19

None

Question 20

What effect will an hypotonic solution have on RBCs?

Answer 20

Increased volume (swelling and hemolysis)

Question 21

What effect will an hypertonic solution have on RBCs?

Answer 21

Decreased volume (shrinking and crenation)

Question 22

What is the name of the osmostic pressure exerted by proteins?

Answer 22

Oncotic or colloid osmotic presure

Question 23

T/F: Oncotic pressure pushes water out of the vascular space.

Answer 23

False- oncotic pressure pulls water into the vascular space

Question 24

What molecule contributes the most to oncotic pressure?

Answer 24

Albumin

Question 25

What is normal physiological plasma oncotic pressure?

Answer 25

~23 mmHg

Question 26

When is edema formed in hypoalbuminemia?

Answer 26

When albumin is

Question 27

Is the degree of hypoalbuminemia a good prognostic factor in severely ill patients?

Answer 27

Yes

Question 28

What direction does hydrostatic pressure move fluid?

Answer 28

Out of the vascular space

Question 29

What direction does oncotic pressure move fluid?

Answer 29

Into the vascular space

Question 30

What are crystalloid solutions?

Answer 30

Crystalline solids dissolved in water eg- NaCL, glucose, etc

Question 31

Can crystalloids be any tonicity?

Answer 31

Yes!

Question 32

T/F: Balanced electrolyte solutions have a composition similar to ECF.

Answer 32

True eg- Normosol and LRS

Question 33

What are balanced electrolyte solutions used for?

Answer 33

Replacement therapy

Question 34

T/F: Balanced electrolyte solutions can be given quickly in large volumes and do not cause changes in electrolyte balance

Answer 34

True!

Question 35

T/F: Balanced electrolyte solutions can be given in large amounts to hypoalbuminemic patients.

Answer 35

False- dilutes what little is left

Question 36

What fraction of a balanced electrolyte solution will stay intravascularly after 30 min?

Answer 36

only 1/3

Question 37

What is an indication for a balanced electrolyte solution?

Answer 37

1. Replacement after blood loss | 2. Initial phase of shock treatment

Question 38

Should maintenance solutions be used peri-operatively?

Answer 38

Typically not appropriate

Question 39

What are the Na and K levels in a maintenance fluid compared to plasma levels

Answer 39

Na- 50% | K- 4-6x

Question 40

What is the daily volume demand when considering maintenance fluids?

Answer 40

40-60mL/kg

Question 41

What percent NaCl is hypertonic saline?

Answer 41

7.5%

Question 42

What are the indications for hypertonic saline?

Answer 42

- Quick IV volume expansion - Severe shock - Head injury with elevated ICP

Question 43

What does hypertonic saline due to increase ICF volume?

Answer 43

Rapidly draw water out of the ECF

Question 44

What are contraindications for hypertonic saline?

Answer 44

- Uncontrolled haemorrhage - Dehydration - Cardiac dysrhythmias

Question 45

What percentage dextrose is considered isotonic?

Answer 45

5%

Question 46

T/F: 5% dextrose becomes hypotonic once metabolized

Answer 46

True

Question 47

T/F: Colloids contain large molecules that stay inside blood vessels.

Answer 47

True- increase plasma oncotic pressure and vascular volume

Question 48

When should colloids be considered?

Answer 48

When albumin is

Question 49

What are some issues with colloids?

Answer 49

- Volume overload - Allergic reaction Possible effect on hemostasis (bleeding tendency)

Question 50

What are the types of colloids?

Answer 50

- Hydroxy-ethyl starch - Dextran - Gelatine - Albumin - Plasma - Whole blood

Question 51

What are the most common Hydroxy-ethyl starches?

Answer 51

Hetastarch and vetstarch

Question 52

T/F: HES can alter hemostasis at high doses or in already sick animals

Answer 52

True

Question 53

What type of fluid is associated with renal failure in septic patients in humans?

Answer 53

HES

Question 54

Should crystalloids be given over colloids in shock patients?

Answer 54

Yes

Question 55

What is the max dose for HES?

Answer 55

20mL/day/kg (half for cats)

Question 56

What route can crystalloids be administered?

Answer 56

IV, IO, SC, IP

Question 57

What are the three ways water is lost?

Answer 57

Physiological- renal, GIT, etc Pathological- vomiting/diarrhea etc Anesthesia- open cavities

Question 58

What are the reasons to give IV fluids during anesthesia?

Answer 58

1. Maintain patent IV catheter 2. Compensate for vasodilation 3. Increase preload/CO 4. Compensate for dehydration 5. Replace ongoing fluid losses

Question 59

What is the standard fluid rate for anesthesia?

Answer 59

10 mL/kg/hr for crystalloids 5mL for young animals 1-2 for cardiac failure, anuria, or lung edema 2mL/kg/hr for colloids

Question 60

Should fluids be bolused in cases of hypotension?

Answer 60

Yes- 10mL/kg