Fluid Therapy - Crystalloids

?% of body weight is water

60

intracellular fluid makes up ?% of body weight

40%

extracellular fluid makes up ?% of body weight

20%

fluid within blood vessels (intravascular) fluid makes up ?% of BW

5%

fluid around cells and outside blood vessels (interstitial) makes up ?% of BW

15%

Compared to the extracellular fluid, what is the sodium and potassium content within the cells?

Sodium = lower in cells

Potassium = higher in cells

3 multiple choice options

? concentration determines intravascular volume

sodium

total body ? determines hydration

sodium

What are some methods used to calculate daily water requirements?

1. Calculate based on daily resting energy requirement equation

2. Estimate daily water requirements based on size

Equation for daily maintenance requirement based on daily resting energy requirement?

70 x BW^0.75 = mL/kg/day

daily water requirement estimate for giant breed dogs?

30ml/kg/day

daily water requirement estimate for large breed dogs?

40ml/kg/day

daily water requirement estimate for medium dogs and cats ?

50ml/kg/day

daily water requirement estimate for small breed dogs?

60ml/kg/day

daily water requirement estimate for neonates?

80-100ml/kg/day

interstitial/intracellular fluid loss that usually occurs slowly over several days to weeks and can be replaced slowly

dehydration

1 multiple choice option

intravascular fluid loss that usually occurs more rapidly and requires rapid restoration of blood volume

hypovolemia

1 multiple choice option

fluid loss via urine, feces, vomitus, or wound exudates

sensible fluid loss

1 multiple choice option

fluid loss via sweat, saliva, or excessive panting

insensible fluid loss

1 multiple choice option

when fluid loss exceeds fluid intake

dehydration

volume of fluid needed to replace the dehydration deficit is estimated by the equation

BW(kg) x % dehydration = volume of fluid deficit (L)

dehydration can cause hypovolemia once it is greater than ?%

10%

Rate at which a dehydration fluid deficit needs to be replaced will depend on

-Severity

-If heart disease is present

-If renal disease is present

does hypovolemia require rapid intervention?

yes

1 multiple choice option

for hypovolemia, give fluid boluses of ? ml/kg when using isotonic fluids then reassess

10-20ml/kg

solutions containing electrolyte and nonelectrolyte solutes capable of entering all fluid compartments

crystalloids

What are the two major determinants of fluid balance within the body?

Sodium

Albumin

List three different characteristics used to describe a crystalloid solution?

Tonicity

Buffers

Balanced

effective osmolality of a solution

tonicity

What is the buffer added to Normosol-R?

Acetate

What is the buffer added to LRS?

Lactate

if a fluid's composition resembles that of extracellular fluid, it is said to be

balanced

Examples of balanced fluids?

LRS

Normosol-R

Plasmalyte 148

Examples of unbalanced fluids?

Normal saline (0.9% NaCl)

5% dextrose in water

What would happen if you bolus water IV?

cell rupture/lysis

TF there are some cases in which water should be given IV

F

never

fluids used to replace the daily obligate losses of water and solutes in pts that are not eating and drinking (rarely used in vet med)

maintenance fluids

Maintenance fluids are generally ? in sodium and chloride, and ? in potassium

lower

higher

3 multiple choice options

what is the general tonicity of maintenance fluids?

hypotonic

Examples of maintenance fluids?

0.45% NaCl

Normosol M

Home-made concoctions

Plasmalyte 56

most common type of fluid used in vet med used to replace a fluid deficit from the intravascular and interstitial spaces (e.g. hypovolemia, dehydration)

replacement fluids

composition of ? fluids is similar to ECF

replacement

1 multiple choice option

what is the general tonicity of replacement fluids?

isotonic

Examples of replacement fluids?

0.9% NaCl

LRS

Normosol-R

Plasma-lyte A or 148

fluids often used for rapid volume expansion or reduction of ICP by decreasing cerebral edema (e.g. hemorrhagic/hypovolemic shock, head trauma, glaucoma)

hypetonic fluids

Examples of hypertonic fluids?

20% Mannitol

3% Saline

7.5% Saline

possible contraindications for hypertonic fluids?

Severe dehydration

Hypernatremia

When can fluids be discontinued?

1. Rehydration is complete

2. Pt is eating and drinking sufficiently to maintain daily losses

3. On-going losses are under control