Term
| What are some examples of sensible fluid loss? |
|
Definition
| -urination, defecation, vomiting |
|
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Term
| What are some examples of insensible fluid loss? |
|
Definition
| -evaporation: respiration, skin, open body cavities |
|
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Term
| What do baroreceptors respond to? |
|
Definition
-dec in vascular stretch
-dec vagal tone
-inc HR and contractility |
|
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Term
| Briefly describe out the Renin Angiotensin Aldosterone System. |
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Definition
| -responds to dec BP/NA/SNS => Renin released from JG cells =? AT-1 to AT-2 (in lungs) => vasoconstriction, inc adlosterone, inc cardiac vagal response |
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Term
| What percent of the BW is from water? What percentage of that is intacellular? Extracellular? |
|
Definition
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Term
| Is sodium high in ICF, intravascular ECF, or interstitial ECF? What about Potassium? What about chloride? |
|
Definition
-Sodium: high in intravascular and interstitial ECF
-Potassium: highest in intracellular
-Chloride: highest in intravascular and interstitial ECF |
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Term
| What is an effective osmole? Give an example. |
|
Definition
-solutes that cannot cross the cell membrane will contribute to the effective osmolality or tonicity
-ex: Dextrose - |
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|
Term
| What is an ineffective osmole? Give an example. |
|
Definition
-solutes that freely diffuse across the membrane do not contribute to tonicity
-ex: BUN |
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Term
| Describe isotonic crystalloids. What are their function(s)? |
|
Definition
-osmolality similar to plasma
-for the replacement of electrolytes and correction of acid/base disorders
-most common IVF used |
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|
Term
| What do you do if you need to give lots of fluids at once? |
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Definition
| -give a hypertonic solution to pull fluid intravascularly and then replace the fluids slowly with isotonic crystalloids |
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Term
| Is Mannitol or Hypersonic salin solution safer? |
|
Definition
| -Hypertonic saline solutions |
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Term
| What is a hypotonic crystalloid and how does it compare to isotonic crystalloids? |
|
Definition
-lower tonicity than plasma
-Na and Cl is LOW and K is HIGH when compared to isotonic crystalloid sons |
|
|
Term
| What do we normally use hypotonic crystalloids? |
|
Definition
| -maintenance type solutions |
|
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Term
| What is the primary concern with administration of hypotonic crystalloids? What are some examples of hypotonic crystalloids? |
|
Definition
-admin slowly
-ex: Normosol-M (Acetate buffer), Plasma-Lyte M (acetate and lactate buffer) |
|
|
Term
| What is a synthetic colloid? |
|
Definition
| -macromolecular particles suspended in crytalloid fluid |
|
|
Term
| What are 3 examples of synthetic colloids? |
|
Definition
-hydroxyethyl starches
-tetrastarch
-hetastarch |
|
|
Term
| What are the 3 major characteristics of dydroxyethyl starches that we are concerned with? |
|
Definition
-mean molecular weight: average weight or numbered average size of the polymers
-molecular substitution: degree of substitution of glucose molecules with hyrodyethyl groups
-C2: C6 ratio: HE groups at the C2 position will inhibit the alpha-amylase better than at the C6 position |
|
|
Term
Describe Tetrastarch in regards to the following characteristics:
a) speed of degradation
b) concentration
c) MW
d) average
e) MS
f) C2:C6
g) COP
h) expansion |
|
Definition
a) rapidly degraded
b) 6% conc
c) MW 130
d) ave 70-60
e) MS 0.4
f) C2:C6 9:1
g) COP 37 mmHg
h) expansion 130% |
|
|
Term
Describe HEtastarch in regards to the following:
a) speed of degradation
b) concentration
c) MW
d) Average
e) MS
f) C2:C6
g) COP
h) Expansion |
|
Definition
a) slowly degraded
b) 6% concentration
c) MW 450
d) Average 69
e) MS 0.7
f) C2:C6 4:1
g) COP 33 mmHg
h) expansion 100% |
|
|
Term
| What are some possible adverse effects with Hetastarch? |
|
Definition
|
|
Term
| In what patients is hetastarch contraindicated? |
|
Definition
| -patients with renal dysfunction |
|
|
Term
| IN what animals should we use synthetic colloids? |
|
Definition
-dec COP
-severe hypoproteinemia
-need for volume expansion |
|
|
Term
| What are two examples of natural colloids? |
|
Definition
-plasma
-albumin (canine or human)
-fresh whole blood
-packed RBC |
|
|
Term
| When would we give plasma? |
|
Definition
| -coagulopathies, liver disease, rodenticide toxicity, hemophilia, etc |
|
|
Term
|
Definition
| -inability to deliver oxygen or the consumption is greater than the delivery leading to inadequate celluar energy production |
|
|
Term
| How does compensated shock present clinically? |
|
Definition
-tachycardia
-hypertension
-increased CRT |
|
|
Term
| How do cats in shock appear? |
|
Definition
-brady or tachycardic
-pale MM
-cold extremities, hypothermia |
|
|
Term
| What are the shock organs for the dog and horse? What about for cats, cattle, and pigs? |
|
Definition
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|
Term
| What is hypovolemia? Give some examples of some causes. |
|
Definition
-dec in circulating blood volume
-ex: hemorrhage, severe dehydration (intestinal obstruction, GDV, colic, displaced abomasum, burns) |
|
|
Term
| What is cardiogenic shock? |
|
Definition
| -dec in forward flow to the heart |
|
|
Term
| What are the 4 hallmarks of cardiogenic shock? |
|
Definition
| -dec CO, dec venous return, dec SV, usually no vasodilation |
|
|
Term
| IS cardiogenic shock acquired or congenital? |
|
Definition
|
|
Term
| True or False: Cardiogenic shock is usually associated with volume loss. |
|
Definition
| -FALSE, usually NOT associate dwith volume loss |
|
|
Term
| What are the main two types of vascular shock? |
|
Definition
-distributive
-obstructive |
|
|
Term
| What is distributive vascular shock and what are some examples? |
|
Definition
-vessels cannot respond to constrict so massive vasodialtion everywehre
-ex: sepsis, neurogenic, anaphylactic |
|
|
Term
| What are some examples of obstructive vascular shock? |
|
Definition
-pericardial effusion
-severe HW dz
-GDV, colic, etc |
|
|
Term
|
Definition
| -immense systemic inflammatory response leading to a surge of cytoking release (inc vascular perm, causes coagulation abnormalitites, etc), persisitent hypotension |
|
|
Term
| Describe canine SIRS classification. |
|
Definition
-greather than 40C or less than 38C
-HR > 120 bpm
-/+ hyperventilation, hypotensive, hypoglycemia
-high WBC |
|
|
Term
| Describe felie CIRS classification. |
|
Definition
-usually hypothermic
-low to inc HR
-/+ hyperventilation, hypotensive, hypoglyceia, anemia
-high to low WBC |
|
|
Term
| Give an example of neurogenic shock. |
|
Definition
-spinal cord trauma
-causes loss of vasomotor control |
|
|
Term
| What results from anaphylactic shock? |
|
Definition
| -massive histamine release |
|
|
Term
|
Definition
| -shock cuased by deranged cellular metabolic machinery |
|
|
Term
|
Definition
| -dec oxygen content in arterial blood |
|
|
Term
| With transfusions during surgery, at what point of blood loss do we seee profound CV disturbances? |
|
Definition
|
|
Term
| At what point do we give an infusion? |
|
Definition
-15-20% blood loss
-concentration of Hb below DO2 (extent that anaerobic met will ensue)
-look at: intravascular vol, evidence of shock, acute vs chronic, CV parameters |
|
|
Term
|
Definition
-fludis
-inotropic or vasopressor support
-antibiotics
-protectants
-LOTS of monitoring |
|
|
Term
| Why do we need to maintain circulatory volume with perioperative fluid therapy? |
|
Definition
| -optimize end-organ perfusion and oxygen delivery |
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