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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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.
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Vet. Clin. North Am. Small Anim. Pract. · May 2008
ReviewAssessment and treatment of hypovolemic states.
Hypovolemia and hypoperfusion are common life-threatening problems in animals presented to the emergency veterinarian. Assessment of physical findings and rapid recognition and treatment of abnormal tissue perfusion are crucial in optimizing outcome. The clinician should be familiar with the disease being treated and the types of fluids that are available. Development of a fluid therapy plan to correct life-threatening abnormalities and patient monitoring during treatment play an important role in patient outcome.
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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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The intravenous administration of fluids is one of the most important aspects of patient care in hospitalized animals. Intravenous fluids are administered to replace or prevent dehydration, treat hypovolemic shock and intravascular volume depletion, correct acid-base and electrolyte abnormalities, and maintain vascular access for administration of drugs, blood product components, and parenteral nutrition. Intravenous catheterization also can provide a means of blood sample collection, thus avoiding frequent and uncomfortable venipunctures in critically ill animals. Although the benefits of intravenous catheterization and fluid administration are numerous, inherent risks are associated with the procedures, and care must be taken to avoid potential complications.