- interstitial fluid (ISF) - plasma - transcellular fluid

Fluids Flashcards by Chang Shu

what percentage of a mature dog is water? young animal?

60%; 70%

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what are the two main types of BODY fluids

Intracellular and extracellular

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what creates and maintains the differences between ICF and ECF

cells (via cell membranes)

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ECF consists of (3)

interstitial fluid (ISF)
plasma
transcellular fluid

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what is the 60-40-20 rule

60% of BW is water
40% of BW is intracellular (2/3)
20% of BW is extracellular (1/3)

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what is ICF a mixture of? is this homogenous?

potassium, organic ions and proteins

not homogenous

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what is the pH of ICF? what determines and what maintains this?

close to 7; maintained by Na/K ATPase and determined by K+ in the ICF

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what is ECF a mixture of?

NaCl and NaHCO3

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describe the following fluids:
- Interstitial fluid
- Plasma
- Transcellular fluid

Interstitial fluid: surrounds cells but does not circulate (3/4 ECF or 15% BW)

Plasma: extracellular component of blood (1/4 ECF or 5% BW)

Transcellular fluid: extracellular fluid oustide the normal compartments (CSF, digestive juices, mucus…) (<1% BW)

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what is the pH of ECF?

7.4-7.45

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what is electroneutrality

the number of cations (+) and anions (-) in the ICF and ECF (interstitial and plasma) balances to a net 0 charge in each compartment, although the total number of molecules in each compartment may differ

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In a spun sample of blood, what is the percentage of:
- plasma
- PCV

plasma: 55-65%
pcv: 35-45%

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What is the blood volume of the following species (in ml/kg and % bw)
1) dog
2) cat
3) horse
4) ruminant
5) pig

1) dog: 80 ml/kg (8% bw)
2) cat: 50-70 ml/kg (5-7% bw)
3) horse: 100 ml/lg (10% bw)
4) ruminant: 60 ml/kg (6% bw)
5) pig: 65-75 ml/kg (6.5-7.5% b)

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what is osmolality? how do we calculate it

= ratio of solutes/volume

= 2 x Na + Glucose + BUN mOsm/L

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what is the normal osmolality of ICF, ECF and plasma

290 +/- 10 mOsm/L

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what is Starlings equation

J = k (Pc-Pi) - σ (πc - πi) - Qlymph

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what is P and π in Starling’s equation and what do they do

P = hydrostatic pressure (pushes fluid out)
π = oncotic pressure (draws fluid in)

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what is the net effect of fluid dynamics on:
- arterioles
- venules

Fluid moves out of arterioles and goes into venules

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What is the Endothelial Glycocalyx Layer

web of membrane-bound glycoproteins and proteoglycans on the luminal side of endothelial cells associated with various GAG; acts as an active interface between blood and the capillary wall

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what has been replaced in Starling’s equation

πi has been replaced with subglycocalyx

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what is the endothelial glycocalyx layer semi permeable to

anionic macromolecules (ex. albumin)

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what are some situations that compromise that endothelial glycocalyx layer

systemic inflammatory states
- diabetes
- hyperglycemia
- trauma
- sepsis
- surgery

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what are 4 drugs that protect or restore the endothelial glycocalyx layer

N-acetylcysteine
antithrombin III
hydrocortisone
sevoflurane

T/F absorption through venous capillaries and venules does not occur

Does πc oppose or reverse filtration? What does it do to absorption?

opposes; it does NOT promote absorption

What happens to most of the fluid filtered into the interstitial space

returns to circulation as lymph

what determines if the capillary bed will filter big molecules or not (ex. albumin)

the endothelial glycocalyx layer and basement membrane fenestrations in the capillary

Fill out the following for plasma characteristics of herbivores/humans: - type of buffer - osmolality - Na+ - K+ - Cl-

type of buffer: bicarbonate osmolality: 290 mOsm/L Na+: 140 K+: 3-5 Cl-: 100

Maintenance solutions match ___________ whereas replacement solutions match _______________

daily losses of electrolytes; electrolytes composition of the blood

State whether the following solutions are isotonic, hypotonic, or polyionic (can use more than one) 1) Maintenance solutions 2) Replacement solutions

Maintenance solutions: polyionic, hypotonic Replacement solutions: polyionic, isotonic

When would we use replacement fluids? Maintenance fluids?

Replacement fluids: to replace blood loss or dehydration Maintenance fluids: ICU patient anorexic with no other problems

T/F we can we replacement fluids as maintenance but not maintenance fluids as replacement

what are 4 examples of maintenance solutions

- Plasmalyte-56 - Normosol-M - NaCl 0.45% (+KCl) - Replacement + KCl

Maintenance solutions can be used to replace two types of losses, what are they and what are the maintenance ratets?

1) sensible losses (urine production) 2) Insensible losses (breathing, sweating, feces) 2-4 ml/kg/h

what are some examples of replacement solutions

- Normosol-R - Plasmalyte-A - Plasmalyte-148 - LRS - NaCl 0.9% (+/- KCl)

what is the replacement rate when using replacement fluids

5-10 ml/kg/h

The rate of replacement fluid administration consists of

maintenance requirements + blood/fluid loss

what is another name for replacement fluids

crystalloids

what percentage of replacement fluids/crystalloids stay within the vascular space after 1-2h and what is the practical consequence when treating blood loss

30%; we replace the amount of blood loss with 3x the amount of crystalloids

T/F crystalloids have oncotic pressure

blood loss of less than what % can be effectively treated with crystalloids under anesthesia

10%

what is the shock rate

60 ml/kg/h

what is the rate when administering hypertonic saline

1-2 ml/kg/h

what is the effect of hypertonic saline

draws fluid into the vascular space; effect lasts <60min

what are some examples of colloids

natural: plasma synthetic: dextrans, starches (hetastarch, pentastarch, tetrastarch)

what is the rate of colloid administration and ratio

1:1; 5-10 ml/kg/h

how long do colloids stay in the blood and what effect on oncotic pressure do they have

6-16h; 1.5-2x oncotic pressure of blood

it is best to use what relative size of colloids

smaller; less impact on clotting and less risk of kidney damage

are synthetic colloids currently recommended? why or why not?

no - can achieve shock reversal equally fast with crystalloids - marginally lower volumes needed with colloids - risk of renal damage with pentastarch

hemoglobin is what proportion of PCV

1/3

when would the following be indicated: - blood transfusion - plasma transfusion

blood: if PCV < 20-25% plasma: if TP < 3.5-4 g/dL

(make sure you review how to calculate volume of plasma and volume of blood to give)

what ratio should plasma or blood be given in relation to blood loss

1:1

what is the plasma/blood transfusion rate

5-10 ml/kg/h

when correcting dehydration you should give fluids over how many hours

12-24