Fluid Therapy Flashcards Preview

Anesthesiology > Fluid Therapy > Flashcards

Flashcards in Fluid Therapy Deck (60):
1

What are the roles of water in the body?

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

2

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

60%

3

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

~80%

4

Is % water higher or lower for obese animals?

Lower

5

What percentage of water is in ICF?

40%

6

What percentage of water is in ECF?

20%

7

What percentage of water is in IVF?

5%

8

What percentage of water is in ISF?

15%

9

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

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

10

T/F: Cell membranes are permeable for water.

True- impermeable to ions

11

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

True- impermeable for large molecules

12

What ion is in the highest concentration in ICF?

Potassium

13

What ion is in the highest concentration in ECF?

Sodium

14

What molecule is the highest concentration in IVF?

Albumin

15

The movement of water across semipermeable membranes is called?

Osmosis

16

What is osmolality?

Number of molecules per kg of water

17

What is the pressure required to prevent water movement called?

Osmotic pressure

18

What is the normal osmolality of ECF/ICF?

~300 mOsm/kg

19

What effect will an isotonic solution have on RBCs?

None

20

What effect will an hypotonic solution have on RBCs?

Increased volume (swelling and hemolysis)

21

What effect will an hypertonic solution have on RBCs?

Decreased volume (shrinking and crenation)

22

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

Oncotic or colloid osmotic presure

23

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

False- oncotic pressure pulls water into the vascular space

24

What molecule contributes the most to oncotic pressure?

Albumin

25

What is normal physiological plasma oncotic pressure?

~23 mmHg

26

When is edema formed in hypoalbuminemia?

When albumin is

27

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

Yes

28

What direction does hydrostatic pressure move fluid?

Out of the vascular space

29

What direction does oncotic pressure move fluid?

Into the vascular space

30

What are crystalloid solutions?

Crystalline solids dissolved in water

eg- NaCL, glucose, etc

31

Can crystalloids be any tonicity?

Yes!

32

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

True

eg- Normosol and LRS

33

What are balanced electrolyte solutions used for?

Replacement therapy

34

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

True!

35

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

False- dilutes what little is left

36

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

only 1/3

37

What is an indication for a balanced electrolyte solution?

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

38

Should maintenance solutions be used peri-operatively?

Typically not appropriate

39

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

Na- 50%
K- 4-6x

40

What is the daily volume demand when considering maintenance fluids?

40-60mL/kg

41

What percent NaCl is hypertonic saline?

7.5%

42

What are the indications for hypertonic saline?

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

43

What does hypertonic saline due to increase ICF volume?

Rapidly draw water out of the ECF

44

What are contraindications for hypertonic saline?

- Uncontrolled haemorrhage
- Dehydration
- Cardiac dysrhythmias

45

What percentage dextrose is considered isotonic?

5%

46

T/F: 5% dextrose becomes hypotonic once metabolized

True

47

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

True- increase plasma oncotic pressure and vascular volume

48

When should colloids be considered?

When albumin is

49

What are some issues with colloids?

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

50

What are the types of colloids?

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

51

What are the most common Hydroxy-ethyl starches?

Hetastarch and vetstarch

52

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

True

53

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

HES

54

Should crystalloids be given over colloids in shock patients?

Yes

55

What is the max dose for HES?

20mL/day/kg (half for cats)

56

What route can crystalloids be administered?

IV, IO, SC, IP

57

What are the three ways water is lost?

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

58

What are the reasons to give IV fluids during anesthesia?

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

59

What is the standard fluid rate for anesthesia?

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

2mL/kg/hr for colloids

60

Should fluids be bolused in cases of hypotension?

Yes- 10mL/kg