ECC- Fluid Therapy

What % of body weight is intracellular fluid?

40% 2/3 of body water

What % of body weight is extracellular fluid?

20% of body weight 1/3 of total body water

What are the three major effectors of circulating volume?

Sympathetic nervous system

Renin/angiotensin

Renal sodium excretion

Are fluids drugs?

YES

What are the four phases of fluid therapy?

Resuscitation

Optimization

Stabilization

De-escalation

What are the fluid routes?

IV

SC

IP

IO enteral

What is the fluid dose for immediate resuscitation in cats?

5-10ml/kg

Over 15-30 min

What is the fluid dose for immediate resuscitation in dogs?

10-20ml/kg

Over 15-30min

What is time frame for rehydration ?

Fluid deficit is calculated and given over 12-24 hours

SC where possible

How do you give resuscitated fluids?

IV fluid bolus

Buffered isotonic

Should you withhold fluids in patients with urethral obstruction?

No - address hypovolemia and replenish intravascular volume

Whats the recommended IVFT rate for dogs?

5ml/kg/hr

What is the recommended IVFT rate for cats?

3ml/kg/hr

Who is at an increased risk of fluid overload?

Patients with impaired renal function

Unable to increase urine output and effectively excrete excess fluid

Can K containing fluids be used in hyperkalemic patients?

Yes- balanced isotonic crystalloids buffer acidosis and do not worsen it or cause rapid increase in sodium

Does FFP increase albumin?

Nutritional support is MORE effective- less challenging, less risky, and less costly

Takes 22ml/kg of plasma to increase serum albumin by 0.5g/dL

What is something to be cautious with with synthetic colloids?

Vasculitis- colloids may leak into the interstitial space and worsen interstitial edema

Also avoid in patients with AKI, sepsis or bleeding

When should IVFT be used during CPR?

Hypovolemia

Otherwise don't use it because it will increase right atrial pressure and decrease cerebral perfusion pressure