Fluids

Question 1

How much of total body weight is water?

Answer 1

70%

Question 2

How many liters does intracellular fluid make up?

Answer 2

30 L, 2/3 total body water

Question 3

How many liters does extracellular fluid make up?

Answer 3

15L, 1/3 total body water

Question 4

How many liters does intravascular fluid make up?

Answer 4

5 L (3L plasma and 2 blood)

Question 5

How many liters does extravascular fluid make up?

Answer 5

12 L (tissues adjacent to microvasculature) (the third space)

Question 6

What does a positive tilt test indicate?

Answer 6

A 20% loss in fluid volume

Question 7

What does hypotension in the supine position indicate?

Answer 7

A 30% deficit in blood volume

Question 8

How do you calculate maintenance fluid requirements?

Answer 8

4-2-1:100-50-20 rule
4 ml/kg/h for the first 10 kg
2 ml/kg/h for the next 10 kg
1 ml/kg/hr for the other kg
or 100 ml/kg/day for the first 10, 50 for next 10 and then 20 for every kg after

Question 9

How do you calculate the deficit?

Answer 9

Multiply the maintenance fluid requirement by the hours of fasting

Question 10

How fast do you infuse the deficit?

Answer 10

Over 3 hours. Half of fluid in first hour and the second half over 2 hours

Question 11

What are the daily requirements of sodium?

Answer 11

2mmol/kg

Question 12

What are the daily requirements for potassium?

Answer 12

1 mmol/kg

Question 13

How many cc of crystalloid is equal to 1 cc of blood?

Answer 13

3 cc

Question 14

How many cc of colloid is equal to 1 cc of blood?

Answer 14

1 cc

Question 15

How many mL are lost for minimal trauma to the tissues?

Answer 15

4 ml/kg/hr

Question 16

How many mL are lost for moderate tissue trauma without significant bowel exposure?

Answer 16

6 ml/kg/hr

Question 17

How many mL are lost for severe tissue trauma?

Answer 17

8 ml/kg/hr

Question 18

What are crystalloid solutions?

Answer 18

Usually contain glucose or saline

Good for replacement of insensible losses

Question 19

What can crystalloid solutions cause?

Answer 19

edema in the interstitium due to decrease plasma oncotic pressure.

Question 20

What can large quantities of NS result in?

Answer 20

Hyperchloremic metabolic acidosis

Question 21

What can large quantities of LR result in?

Answer 21

Metabolic alkalosis due to increased production of bicarb from lactate

Question 22

What are colloids?

Answer 22

Homogenous noncrystalline substances consisting of large molecules dissolved in solute.

Question 23

What are the advantages of colloids?

Answer 23

Maintain intravascular space

Question 24

What side effect has been reported with colloids?

Answer 24

Hypersensitivity reaction

Coagulation abnormalities

Question 25

What are the coagulation abnormalities associated with colloid?

Answer 25

Dextran inhibits platelet aggregation and adhesiveness

Hydroxyethyl starch leads to a reduction in factor VIII and vWF

Question 26

What are the types of colloids use today?

Answer 26

Albumin, Hydroxyethyl starch, dextran

Question 27

What is albumin made from?

Answer 27

Human plasma that is pasteurized

Question 28

What is hydroxyethylstarch made from?

Answer 28

amylopectin, kind of like glycogen

Question 29

What’s the half life of albumin?

Answer 29

16 hours

Question 30

What’s the half life of hydroxyethyl starch?

Answer 30

17 days

Question 31

What is dextran made from?

Answer 31

Sucrose from the bacteria Leuconostoc mesenteroides.

Question 32

What is Dextran 40 known for?

Answer 32

improving blood flow in the microvasculature due to decreased blood viscosity