types of fluid

Question 1

What are the four major groups of intravenous fluids?

Answer 1

Crystalloids, synthetic colloids, blood products, and haemoglobin-based oxygen carriers (HBOCs)

Question 2

What do crystalloids contain that allows them to cross the capillary endothelium?

Answer 2

Electrolytes and other solutes

Question 3

What is the main difference between crystalloids and colloids?

Answer 3

Colloids contain macromolecules restricted to the intravascular space

Question 4

What are balanced crystalloids?

Answer 4

Crystalloids with electrolyte levels similar to plasma

Question 5

What are unbalanced crystalloids?

Answer 5

Crystalloids with electrolyte content substantially different from plasma

Question 6

Factors to consider when choosing a crystalloid fluid include:

Answer 6

Osmolality/tonicity, electrolyte content, presence of buffers

Question 7

What is the osmolality of normal plasma?

Answer 7

Around 300 mOsm/kg

Question 8

Define hypertonic solutions.

Answer 8

Fluids with osmolality greater than that of plasma

Question 9

What is the only hypertonic solution available?

Answer 9

Hypertonic saline (HTS)

Question 10

Typical concentration of HTS used in the UK is:

Answer 10

Around 7.2%

Question 11

What effect does HTS have on fluid compartments?

Answer 11

Pulls water from intracellular to extracellular space

Question 12

What is the typical bolus dose of HTS for dogs?

Answer 12

5 mL/kg

Question 13

True or False: HTS expands intravascular volume by more than the amount administered.

Answer 13

True

Question 14

HTS should be administered over not less than ______ minutes.

Answer 14

5

Question 15

What is a potential adverse effect of HTS if given too quickly?

Answer 15

Reflex bradycardia, hypotension, and bronchoconstriction

Question 16

What are isotonic crystalloid solutions used for?

Answer 16

To replace fluid losses from the extracellular space

Question 17

Examples of isotonic crystalloid solutions include:

Answer 17

Hartmann’s solution and 0.9% saline

Question 18

What is the osmolality range of isotonic crystalloids?

Answer 18

272-308 mOsm/L

Question 19

What can excessive use of isotonic crystalloids lead to?

Answer 19

Electrolyte imbalances

Question 20

What is the acidifying effect of 0.9% NaCl attributed to?

Answer 20

High chloride content

Question 21

Hypotonic crystalloids are characterized by:

Answer 21

Low sodium and high potassium levels

Question 22

What should NEVER be administered as a bolus due to risk of cerebral oedema?

Answer 22

Hypotonic solutions

Question 23

What are free water solutions primarily used to treat?

Answer 23

Hypernatraemia

Question 24

Synthetic colloids are solutions containing:

Answer 24

High molecular weight molecules that do not readily cross capillary endothelium

Question 25

Three main groups of synthetic colloids include:

Answer 25

Hydroxyethyl starch (HES), dextrans, and gelatins

Question 26

What is the main indication for HES?

Answer 26

As a resuscitation fluid for hypovolaemic patients

Question 27

What is the maximum recommended dose of Voluven/Volulyte?

Answer 27

50 mL/kg/day

Question 28

What adverse effects are associated with HES in critically ill patients?

Answer 28

Renal dysfunction and increased mortality

Question 29

Dextrans are produced from ______.

Answer 29

Bacterial fermentation of sucrose

Question 30

What are the serious adverse effects associated with dextrans?

Answer 30

Coagulopathies, renal failure, anaphylaxis, and hyperglycaemia

Question 31

Gelatins are produced from ______.

Answer 31

Bovine collagen

Question 32

What is a key concern regarding the use of synthetic colloids?

Answer 32

Adverse effects on renal function

Question 33

What is Gelofusine?

Answer 33

A succinylated gelatin licensed for human use in the UK.

Question 34

How does the half-life of Gelofusine compare to HES?

Answer 34

Considerably shorter than HES.

Question 35

What is a key difference in side effects between Gelofusine and HES?

Answer 35

No dose-related side effects reported for Gelofusine.

Question 36

What adverse effects are reported in people using Gelofusine?

Answer 36

Adverse effects on renal function.

Question 37

What was observed in an experimental study in dogs regarding Gelofusine?

Answer 37

Greater increase in biomarkers of renal injury and renal tubular microvesiculation.

Question 38

What components are found in the plasma of blood?

Answer 38

Albumin and other colloidal molecules.

Question 39

What are fresh whole blood and fresh frozen plasma classified as?

Answer 39

Natural colloids.

Question 40

What is the colloidal property of packed red blood cells?

Answer 40

Contain hardly any plasma and do not have colloidal properties.

Question 41

What is the primary use of plasma products in transfusions?

Answer 41

To treat coagulopathies.

Question 42

What are concentrated human serum albumin solutions (HSA) used for?

Answer 42

Resuscitation in people.

Question 43

What prohibits the veterinary use of HSA solutions?

Answer 43

Serious safety concerns and expense.

Question 44

What is Oxyglobin?

Answer 44

An acellular HBOC licensed for veterinary use.

Question 45

What is the primary indication for Oxyglobin?

Answer 45

To provide oxygen carrying capacity in anaemic dogs.

Question 46

What are the plasma expanding properties of Oxyglobin?

Answer 46

Excellent plasma expanding properties (COP 43 mmHg).

Question 47

What risk does Oxyglobin pose in normovolaemic patients?

Answer 47

May cause fluid overload.