Assessing and Managing Fluid Therapy
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Assessing and Managing Fluid Therapy

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Questions and Answers

What is the recommended time frame to replace fluid deficit in a canine patient with hypovolaemia?

  • 2-4 hours
  • 12-24 hours
  • 24-48 hours
  • 6-8 hours (correct)

    • Which of the following is a marker of dehydration?

  • Increased urine output
  • Tacky mucous membranes (correct)
  • Increased heart rate
  • Decreased blood pressure

    • What is the recommended time frame to replace fluid deficit in a patient with dehydration?

  • 12-24 hours (correct)
  • 2-4 hours
  • 6-8 hours
  • 24-48 hours

    • What is the fluid deficit percentage in a patient with mild depression, slightly prolonged CRT, slightly increased heart rate, increased blood lactate concentration, and concentrated urine?

    <p>5-7%</p> Signup and view all the answers

    What is the fluid deficit percentage in a patient with depressed mental state, cold extremities, dry mucous membranes with a CRT >4 seconds, heart rate >100% above the normal reference range, increased blood lactate concentrations, increased creatinine concentrations, and unlikely to produce any urine?

    <p>12-15%</p> Signup and view all the answers

    What is the consequence of not calculating fluid deficit in practice?

    <p>Incorrect estimation of fluid requirement</p> Signup and view all the answers

    What is the consequence of dehydration in a patient?

    <p>Renal failure</p> Signup and view all the answers

    Which of the following is the recommended rate for restoring intravascular volume in a hypovolaemic patient during shock fluid therapy?

    <p>90ml/kg</p> Signup and view all the answers

    What is the recommended duration for giving fluid to a dehydrated patient to allow diffusion into intracellular and interstitial spaces?

    <p>12 - 24 hours</p> Signup and view all the answers

    What is the formula for estimating fluid deficit in a patient?

    <p>% fluid deficit * bodyweight</p> Signup and view all the answers

    What is the equivalent volume of 1 liter of hypertonic saline in terms of isotonic fluids?

    <p>3 - 5 liters</p> Signup and view all the answers

    In a horse with colic requiring surgery, what is the recommended approach to stabilizing the horse and improving intravascular volume prior to anesthesia with a fluid challenge approach?

    <p>Give 2 liters of hypertonic saline</p> Signup and view all the answers

    What is the recommended fluid challenge volume for a cat, sheep, or goat?

    <p>10ml/kg</p> Signup and view all the answers

    What is the recommended fluid challenge volume for a dog, horse, or pig?

    <p>20ml/kg</p> Signup and view all the answers

    In patients with strangulating lesions, why is time to surgery important?

    <p>To improve prognosis</p> Signup and view all the answers

    What is the recommended approach for administering fluids in large animal practice once the fluid deficit in liters is calculated?

    <p>Administer half as a bolus and replace the other half as maintenance over 6-8 hours</p> Signup and view all the answers

    What is the recommended duration for giving fluid to a dehydrated patient with a 5% deficit or less?

    <p>6 - 8 hours</p> Signup and view all the answers

    What are the quantitative markers used to measure hypovolaemia?

    <p>HR, CRT, PCV/TS, Lactate, Urine Output</p> Signup and view all the answers

    What are the markers used to assess dehydration?

    <p>Dec BW, Sunken eyes, Tacky MM, Inc skin tent</p> Signup and view all the answers

    What are the clinically detectable signs of fluid deficit of less than 5%?

    <p>Mild depression, Slightly prolonged CRT, Slightly increased heart rate, Increased blood lactate concentration, Creatinine concentration concentrated urine</p> Signup and view all the answers

    What are the clinically detectable signs of fluid deficit of 10%?

    <p>Depressed, May have cold extremities, Dry mucous membranes with a CRT &gt;3 seconds, Heart rate &gt;50% above the normal reference range, Increased blood lactate concentration, Increased creatinine concentrations, Small volume of very concentrated urine</p> Signup and view all the answers

    What are the clinically detectable signs of fluid deficit of 12-15%?

    <p>Depressed, Cold extremities, Dry mucous membranes with a CRT &gt;4 seconds, Heart rates &gt;100% above the normal reference range, Increased blood lactate concentrations, Increased creatinine concentrations, Unlikely to produce any urine</p> Signup and view all the answers

    What is the recommended approach for fluid therapy in a hypovolaemic patient during shock?

    <p>Give half of the calculated fluid deficit as a bolus and then replace the other half as maintenance over 6-8 hours.</p> Signup and view all the answers

    What is the recommended approach for fluid therapy in a dehydrated patient with a 5% deficit or less?

    <p>Give the fluid over 12-24 hours to allow diffusion from the intravascular space into the intracellular and interstitial spaces.</p> Signup and view all the answers

    How can the fluid deficit in liters be calculated?

    <p>Fluid deficit (in liters) = % fluid deficit \times bodyweight</p> Signup and view all the answers

    What is the recommended approach for fluid therapy in a horse with colic requiring surgery?

    <p>Stabilize the horse and improve intravascular volume prior to anesthesia by giving a fluid challenge of 10 liters of Hartmann's solution and reassessing, possibly followed by another 10 liters of Hartmann's solution.</p> Signup and view all the answers

    What is the equivalent volume of 1 liter of hypertonic saline in terms of isotonic fluids?

    <p>1 liter of hypertonic saline is equal to 3-5 liters of Hartmann's solution in the short term.</p> Signup and view all the answers

    Study Notes

    Fluid Deficit Replacement

    • Recommended time frame: Replace fluid deficit within 24 hours in hypovolemic canine patients.
    • Fluid deficit percentage:
      • Mild dehydration (5-6%): Slightly prolonged CRT, slightly increased heart rate, increased blood lactate concentration, and concentrated urine.
      • Severe dehydration (10-12%): Depressed mental state, cold extremities, dry mucous membranes with a CRT >4 seconds, heart rate >100% above normal, increased blood lactate concentrations, increased creatinine concentrations, and unlikely to produce any urine.

    Consequences of Not Calculating Fluid Deficit

    • Incorrect fluid therapy: Can lead to overhydration or underhydration, compromising patient health.
    • Dehydration: Leads to various complications including organ dysfunction, shock, and even death.

    Fluid Therapy

    • Shock fluid therapy: Restore intravascular volume rapidly by administering fluids at 3-4 times the maintenance rate.
    • Dehydrated patients: Administer fluids over 24-48 hours to allow diffusion into intracellular and interstitial spaces.
    • Formula for estimating fluid deficit: Fluid deficit (liters) = (Body weight (kg) x % dehydration)/100

    Fluid Challenge

    • Fluid challenge: Administer a bolus of fluids to quickly improve intravascular volume.
    • Recommended volume:
      • Cats, sheep, goats: 20-40 ml/kg.
      • Dogs, horses, pigs: 20-40 ml/kg.

    Specific Cases

    • Strangulating lesions: Time to surgery critical as delayed surgery increases the risk of necrosis and complications.
    • Colic in horses:
      • Stabilize with fluid challenge: Recommended approach to improve intravascular volume prior to anesthesia.
      • Fluid challenge volume: 5-10 ml/kg, repeated as needed.
    • Administering fluids: Once fluid deficit is calculated, administer fluids at a rate that replaces the deficit over the recommended time frame.
    • Dehydration < 5 %: Administer fluids over 24 hours.

    Markers of Dehydration and Hypovolemia

    • Dehydration:
      • Quantitative markers: Increased packed cell volume (PCV), total solids (TS), and urine specific gravity.
      • Clinical signs:
        • < 5 %: Minimal clinical signs.
        • 10 %: Mild depression, slightly prolonged CRT, and tachycardia.
        • 12-15 %: Depressed mental state, prolonged CRT, cold extremities, and weak pulse.
    • Hypovolemia:
      • Quantitative markers: Decreased blood pressure, decreased urine output, and increased heart rate.

    • Hypovolemic patient during shock:

      • Rapid fluid administration at 3-4 times the maintenance rate.
      • Isotonic crystalloids: E.g., lactated Ringer's solution or 0.9% saline should be used.

    • Dehydrated patient (< 5%):

      • Administer fluid deficit at 2-3 times maintenance rate.
      • Duration: About 24 hours.

    Fluid Deficit Calculation

    • Fluid deficit (liters): (Body weight (kg) x % dehydration)/100.

    Equivalency

    • 1 liter of hypertonic saline: Equivalent to 4 liters of isotonic fluids.

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    Description

    Test your knowledge on assessing and managing fluid therapy in patients. Learn about the important markers for hypovolaemia and dehydration, and how to adjust fluid rates and types accordingly.

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