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While the commonly used veterinary crystalloid sterile saline is a 0.9% concentration, hypertonic saline is a solution that is greater than 0.9%. Common medical preparations include ~7% and 23.4% hypertonic saline. Let’s review 3 reasons why you should carry hypertonic saline on your veterinary clinic shelf: 1) Paraphimosis: Because of its ...
Hypertonic saline provides a supranormal concentration of sodium and is generally given in a 3%, 7%, or 7.5% IV solution. The effect is to rapidly draw water from the interstitial space into the intravascular space, rapidly expanding the intravascular volume. Hypertonic saline may also decrease cellular swelling and improve myocardial ...
The usual shock dosage of hypertonic saline is 4 to 7 mL/kg in dogs and 3 to 4 mL/kg in cats, administered over approximately 10 minutes. Infusion rates greater than 1 mL/kg/min may cause a vagally mediated bradycardia, vasodilation, and bronchoconstriction.
Dec 8, 2016 · Hypertonic Saline is fast acting, but short-lived to less than one hour. The administration of this fluid therapy poses a risk for abnormal heart rhythms and can’t be used in dehydrated patients. The solutions actually pulls water from the intracellular and interstitial sites in the dog’s body, creating a disturbance in electrolyte values.
- Types of Fluid Loss
- Determining Fluid Deficits
- Method of Delivery
- Types of Fluid
- Determining A Fluid Rate
- Summary
Fluid loss in small animals can be isotonic, hypotonic, or hypertonic. While osmolality is a measure of all solutes in solution, tonicity refers only to the effective solutes in solution; that is, those that cannot cross a membrane and so exert an osmotic pressure. Isotonic losses, such as those observed with vomiting and diarrhea, occur when the f...
Assessment of Hydration
Dehydration refers to lack of fluid in the interstitial compartment, whereas hypovolemia describes lack of fluid in the intravascular compartment. Intracellular dehydration cannot be detected on physical examination and is primarily assessed via changes in sodium concentration. Although dehydrated patients have some hypovolemia, clinical changes do not occur until dehydration exceeds 10%.1 The minimum percentage dehydration that can be detected on physical examination is 5%, and dehydration g...
Assessment of Intravascular Volume
Intravascular volume can also be assessed on physical examination. Signs of decreased intravascular volume, or hypovolemia, include increased heart rate, fair or weak pulses, coolness of the distal limbs, weakness, and pale mucous membranes. Although blood pressure can initially be normal or even high in the early stages of hypovolemic shock, a normal blood pressure in conjunction with physical examination findings consistent with hypovolemia should not dissuade clinicians from considering hy...
The 4 primary means of fluid delivery are intravenous (IV), intraosseous, subcutaneous (SC), and enteral. IV fluid administration is generally preferred for hospitalized patients because the delivery rate can be controlled and changed quickly depending on patient requirements. Intraosseous catheters can be placed in neonates, exotic patients, and o...
Crystalloids
Crystalloids are fluids containing small solutes (<500 Da), most of which are electrolytes, in particular sodium and chloride.3 The electrolytes and water in these solutions move easily across the endothelium into the interstitial space. More than 60% to 80% of a crystalloid solution distributes out of the intravascular space within 20 to 30 minutes.3,4Crystalloid solutions can be classified as isotonic, hypotonic, or hypertonic.
Colloids
Colloid solutions contain large molecules (>10,000 Da) and tend to remain in the intravascular space longer than crystalloids.3,4 The most commonly used colloid solutions in veterinary medicine contain hydroxyethyl starch (HES).8 HES solutions are thought to be most effective in treating hypovolemia because the colloid should theoretically remain in the intravascular space, although some extravasation does occur. The half-life of various colloids depends on their molecular properties. As ment...
When deciding if fluid therapy is appropriate for a patient, a few basic questions should be asked before determining a fluid therapy plan (BOX 1). These questions can be answered based on assessment of the patient for hypovolemia and dehydration (see Determining Fluid Deficits). Once the patient’s volume status and hydration needs have been determ...
Fluid therapy is a mainstay of care in the hospitalized small animal patient. Assessment of a patient’s fluid deficits and ongoing needs will help determine what variety of fluid and rate to use.
Hypertonic solutions require careful administration, as large volumes can be fatal. When using a 7.2% solution of hypertonic saline, suggested doses are 2ml/kg to 4ml/kg in cats and 4ml/kg to 7ml/kg in dogs (Auckburally, 2016). Sodium bicarbonate. Sodium bicarbonate is a specific type of hyperosmolar crystalloid solution used for the treatment of
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A rat model of sepsis that compared 0.9% saline with the more balanced crystalloid Plasma-Lyte A for fluid therapy identified worse kidney function in the saline group (83% versus 28%). 9 The concentration of chloride in 0.9% saline solution (154 mEq/L) is higher than that of plasma in healthy animals (average: 110 mEq/L [dogs], 120 mEq/L [cats ...
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