Fluid Therapy Basics

Ed Carlson, CVT

January 2013

Outline

• Importance of water

• Body water compartments

• Ions & Electrolytes

• Dehydration

• What is Fluid Therapy?

• Phases of Fluid Therapy

• Fluid types

• Administration

• Monitoring

Why is water so important?

Body Water Compartment

Osmosis

Ions & Electrolytes

Sodium Potassium Pump

Solution Concentrations

Dehydration

Fluid Therapy

IV vs. SubQ Fluids

Volume and Rate

Resuscitation

Shock patients

Rehydration Phase

Maintenance Phase

Fluid Plan

Fluid Types Used in Veterinary MedicineCrystalloids

Normosol R Lactated Ringers

Solution 0.9% Saline 5% Dextrose in

Water 0.45% Sodium

Chloride + 2.5% Dextrose

Hypertonic Saline

Colloids VetStarch Fresh Frozen

Plasma Frozen Plasma Oxyglobin Human albumin

Crystalloids

Normosol-R

Isotonic 140 mEq / L of Sodium 98 mEq / L of Chloride 5 mEq / L of Potassium 3 mEq / L of Magnesium 27 mEq / L Acetate 23 mEq / L Gluconate

Lactated Ringers Solution

Isotonic

130 mEq / L of Sodium 109 mEq / L of Chloride 4 mEq / L of Potassium 3 mEq / L of Calcium 28 mEq / L of Lactate

0.9% Sodium Chloride

Isotonic

“Normal Saline” 154 mEq / L of Sodium 154 mEq / L of Chloride No other electrolytes

5% Dextrose in Water

Hypertonic

“D5W” 50 g/L of Dextrose No other electrolytes Relatively no caloric content Never given subq

0.45% Sodium Chloride + 2.5% DextroseIsotonic

“Half & half” 77 mEq / L of Sodium 77 mEq / L of Chloride 25 g / L of Dextrose No other electrolytes

Hypertonic Saline

Hypertonic

Concentrations vary Bulger uses 7.2%

Which Crystalloid to Use?

Serum Sodium

Normal Serum Sodium Low Serum Sodium High Serum Sodium

Serum Potassium

Colloids

VetStarch

• Isotonic

6% hydroxyethyl starch in 0.9% sodium chloride

Plasma products

Isotonic

Fresh Frozen Plasma Frozen Plasma

Oxyglobin

Purified solution of bovine hemoglobin

Increases O2 to tissues Expands plasma volume No RCB’s Store at room temp Good for up to 3 years

Human Albumin

5% solution isotonic

25% solution hypertonic

Wear gloves

Indications for Colloidal Therapy

Administration

Administration

Monitoring

Fluid intolerance

Conclusion Fluid therapy is fundamental to many aspects of small

veterinary medicine. IV Fluids are used as a supportive measure in

hospitalized patients, and as life saving measures in many critical patients.

The veterinary technician is responsible for monitoring patients receiving IV fluid therapy, noticing, recording and reporting changes in a patient’s condition. Therefore we must understand the basic principles of fluid therapy.

Questions?