Fluid Types and Routes Flashcards
what are the 4 fluid types?
- water
- crystalloids (most common)
- colloids
- blood products
what are the types of crystalloids?
- hypotonic: D5W, 0.45% NaCl
- isotonic: LRS, 0.9% NaCl
- hypertonic: ex 7.2% NaCl
what are some colloids examples?
- synthetic: hetastarch, vetstarch
- natural: like plasma
blood products
- fresh whole blood
- packed RBC
- plasma products
- platelet products
what are the most important questions to ask when choosing a fluid?
what type?
how much?
how fast?
how can you administer fluids?
- per Os
- subcu
- intraosseous
- IV
- intraperitoneal
how do you choose a fluidi type?
- depends on behavior of fluid when introduced in body
- fluid shifts between ECF and ICF bc of osmolality
- fluid shifts between interstitium and IV compartments bc Starlings forces
- no fluid better than others, but each indications and cons of each need taken into account
what are crystalloids?
a solution with electrolytes dissolved within that solution
hypotonic solution
0.45% NaCL = 145 mOsm/L
means osmolality is less than that of plasma
isotonic crystalloids
0.9% NaCl = 310 mOsm/L
is isotonic compared to plasma
hypertonic crystalloids
7.5% NaCl = 1300 mOsm/L = hypertonic compared to plasma, often used in equine med
how can crystalloids be divided?
based on electrolyte composition and acid base effects
what is the downside of 0.9% NaCl?
it has no bicarbonate precursors and thus is an acidifying solution
what acid base effect does LRS (lactate) have?
alkalinizing: good bc most patients are acidic
what crystalloid is most commonly used?
LRS
what is the fluid behavior of hypotonic crystalloids?
- think of as mix of isotonic fluid and water
- distributed in both ICF and ECF compartments
- volume of distribution depends on the amount of Na in the solution
- isotonic fluid distributes 100% in ECF compartment
- water distributes 67% to ICF and 33% to ECF
how should you think of hypotonic crystalloids?
as isotonic crystalloids + water
T/F: giving a L of D5W is equivalent to giving a L of free water
true
what are indications for hypotonic fluids?
- true maintenance fluid
- free water deficit (ie hypernatremia)
- maintenance fluid when Na restriction is needed (ie renal and heart dz)
what are contra-indications for hypotonic fluids?
- IV compartment volume expansion like shock treatment
- free water gain like hyponatremia
not a good volume replacement because it doesn’t go into the vascular space
side effects of hypotonic crystalloids
- hyponatrremia
- acute changes in blood osmolaliy and fluid shifts
- can see neuro issues and RBC damage
isotonic crystalloids are the most commonly used IV solutions. what is their fluid behavior?
- stays within the ECF: 3/4 in interstitum and 1/4 in intravascular space
- redistribution to interstitium within 20-30 min according to starling’s forces
LRS, plasmalyte, normosol, and physiologic saline are all types of
isotonic crystalloids
what are indications for isotonic crystalloids?
- IV volume expansion: ie txt of shock
- ECF volume expansion: ie rehydration, treatment of dehydration
- replacement of ongoing losses
