The Veterinary clinics of North America. Small animal practice
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Vet. Clin. North Am. Small Anim. Pract. · May 2008
ReviewMetabolic acid-base disorders in the critical care unit.
The recognition and management of acid-base disorders is a commonplace activity in the critical care unit, and the role of weak and strong acids in the genesis of metabolic acid-base disorders is reviewed. The clinical approach to patients with metabolic alkalosis and metabolic acidosis is discussed in this article.
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Colloids are increasingly becoming considered indispensable in the management of critically ill patients. Typical indications for colloid administration include patients with tissue edema, hypovolemia, and low oncotic pressure. ⋯ Newer colloids have been modified to limit effects on the coagulation system, and they may be used to modulate the inflammatory response, which could prove to be particularly useful in the management of critically ill patients. A better understanding of how different fluids influence the host response may enable us to explore new applications of fluid replacement therapy beyond simply replenishing volume deficits.
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Vet. Clin. North Am. Small Anim. Pract. · May 2008
ReviewManaging fluid and electrolyte disorders in renal failure.
Because of the role of the kidneys in maintaining homeostasis in the body, kidney failure leads to derangements of fluid, electrolyte, and acid-base balance. The most effective therapy of a uremic crisis is careful management of fluid balance, which involves thoughtful assessment of hydration, a fluid treatment plan personalized for the specific patient, repeated and frequent reassessment of fluid and electrolyte balance, and appropriate changes in the treatment plan in response to the rapidly changing clinical situation of the patient that has renal failure. Disorders of sodium, chloride, potassium, calcium, and phosphorus are commonly encountered in renal failure and may be life threatening. Treatment of metabolic acidosis and nutritional support are frequently needed.
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Vet. Clin. North Am. Small Anim. Pract. · May 2008
Review Case ReportsMaking sense of blood gas results.
Recent technologic advances have allowed the production and marketing of cage-side blood gas analyzers to private practitioners. The widespread use of cage-side portable blood gas analyzers in veterinary practices has increased the need to develop the basic skills of blood gas analysis as part of a tool kit for practicing veterinarians. Rapid expansion of emergency and critical care medicine as a specialty and increased numbers of veterinary emergency and veterinary specialty practices have occurred concurrently with the availability of blood gas analyzers that are affordable for private practitioners. As a result, evaluation of blood gas results is no longer an activity confined to academic institutions and has become a daily part of many practicing veterinarians' activities.
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Vet. Clin. North Am. Small Anim. Pract. · May 2008
ReviewFluid therapy in patients with pulmonary disease.
Fluid therapy in patients with pulmonary disease is challenging. Although a single set of rules cannot be applied to every patient, the following guidelines can be used when managing patients with pulmonary disease. ⋯ In hypovolemic or hypotensive patients, small boluses of isotonic crystalloids or colloids should be given to restore perfusion, avoiding rates of more than 30 mL/kg an hour for isotonic crystalloids. If perfusion is not restored by adequate volume resuscitation, vasopressors or positive inotropes should be administered to prevent fluid overload and deterioration in pulmonary function.