Fluid therapy and blood transfusion | BSAVA Library

Fluid therapy and blood transfusion

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In the past, the administration of fluids in the perioperative period and in the critical care setting has been largely based on anecdote and/or flawed studies rather than sound evidence. Understanding of body fluid kinetics is rapidly advancing, and recommendations for fluid therapy are changing to keep pace with these developments. This chapters looks at fluid distribution and composition within the body, physical principles and measurements, recognition of fluid deficits, types of fluid loss, routes of fluid administration, types of fluid, blood transfusion, equipment for fluid therapy and blood tranfusion, fluid therapy for anaesthesia, monitoring fluid therapy.

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18.1 Body water distribution between the intracellular and extracellular (plasma plus interstitial) fluid compartments. See text for explanation.
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18.2 Osmosis. Direction of arrow indicates the movement of water. The increased number of particles creates an osmotic gradient allowing the movement of water through the semipermeable membrane so that the concentrations of each compartment become equal.
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18.3 Diagrammatic and mathematical representations of Starling’s forces governing transcapillary fluid movement. A = capillary hydrostatic pressure; B = interstitial hydrostatic pressure; C = capillary oncotic pressure; D = interstitial oncotic pressure. The Starling equation can be simplified as: Filtration = (A – B) – (C – D) or hydrostatic pressure difference – oncotic pressure difference.
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18.4 Schematic representation of the endothelium and the glycocalyx layer in a capillary. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and are printed with her permission.
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18.10 Recommended infusion rates of blood products.
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18.12 A burette (sometimes called a buretrol).
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18.13 An in-line infusion rate, dial type flow controller.
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18.14 A pressure infuser placed around a fluid bag.
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18.15 In-line clot filter for the administration of blood and plasma.
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18.16 In-line filter for use with a syringe for administration of small volumes of blood and plasma.
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18.17 In-line intravenous fluid warming pod. (Courtesy of Tanya Duke-Novakovski, Western College of Veterinary Medicine, University of Saskatchewan, Canada)
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18.19 Graphical representation of goal-directed therapy. See text for explanation. (Adapted and simplified from )
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18.21 Idealized Frank–Starling curve demonstrating changes in stroke volume in response to preload. See text for explanation.
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