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==What is Fluid Therapy?==

==What is Fluid Therapy?==

'''Fluid Therapy''' is the administration of fluids to a patient as a treatment or preventative measure. It can be administered via an intravenous, intraperitoneal, intraosseous, subcutaneous and oral routes. 60% of total bodyweight is accounted for by the total body water. This can further be divided into intracellular or extracellular as shown below.

'''Fluid Therapy''' is the administration of fluids to a patient as a treatment or preventative measure. It can be administered via an intravenous, intraperitoneal, intraosseous, subcutaneous and oral routes. 60% of total bodyweight is accounted for by the total body water. This can further be divided into intracellular or extracellular as shown below.

**A ''isotonic'' solution is one that has an osmotic pressure '''the same''' as plasma.

**A ''isotonic'' solution is one that has an osmotic pressure '''the same''' as plasma.

**A ''hypertonic'' solution is one that has an osmotic pressure '''higher''' than plasma.

**A ''hypertonic'' solution is one that has an osmotic pressure '''higher''' than plasma.

*''''''Hypovolaemia''''' is a reduction in normal blood volume which can be caused by:

*'''''Hypovolaemia''''' is a reduction in normal blood volume which can be caused by:

** Excessive sweating

** Excessive sweating

** Water deprivation

** Water deprivation

====Intra-anaesthetic====

====Intra-anaesthetic====

During an anaesthetic, normal homeostatic functions of the patient are altered and so fluid therapy should be initiated to any patient undergoing an anaesthetic to allow for maintained fluid balance. During any procedure, glucose levels should be closely monitored, especially patients with diabetes, liver disease or paediatric patients. If necessary it is then possible to add glucose or dextrose to the fluid the patient is receiving.  

During an anaesthetic, normal homeostatic functions of the patient are altered and so fluid therapy should be initiated to any patient undergoing an anaesthetic to allow for maintained fluid balance. During any procedure, glucose levels should be closely monitored, especially patients with [[Diabetes Mellitus|diabetes]], [[:Category:Liver - Pathology|liver disease]] or paediatric patients. If necessary it is then possible to add glucose or dextrose to the fluid the patient is receiving.  

Some patients may develop an anaesthetic-induced hypotension from the side-effects of the agents used to induce and maintain anaesthesia. Fluids are therefore often given as a preventative measure. If there is significant blood loss during a procedure, it is necessary to replace these losses, either using blood products or an appropriate fluid.

Some patients may develop an anaesthetic-induced hypotension from the side-effects of the agents used to induce and maintain anaesthesia. Fluids are therefore often given as a preventative measure. If there is significant blood loss during a procedure, it is necessary to replace these losses, either using blood products or an appropriate fluid.

Patients with hepatic diease often have alterations in protein levels due to reduced production, as well as changes in clotting factors. Hypoproteinemia will affect patients undergoing anaesthetics as many agents are protein bound so the reduction in protein means that more of the agent may be available. However, the hypoproteinemia may also be affected by the adminstration of certain fluid types so it is important to have a baseline so that the most appropriate fluid can be selected.  

Patients with hepatic diease often have alterations in protein levels due to reduced production, as well as changes in clotting factors. Hypoproteinemia will affect patients undergoing anaesthetics as many agents are protein bound so the reduction in protein means that more of the agent may be available. However, the hypoproteinemia may also be affected by the adminstration of certain fluid types so it is important to have a baseline so that the most appropriate fluid can be selected.  

If there are any clotting disorders then it may be necessary to give blood products so that the missing clotting factors are available to the patient, while the underlying cause is diagnosed and treated.  

If there are any [[:Category:Coagulation Defects|clotting disorders]] then it may be necessary to give blood products so that the missing clotting factors are available to the patient, while the underlying cause is diagnosed and treated.

===Central Nervous System Disease===

===Central Nervous System Disease===

Patients with head trama or increased intracranial pressure are particularly suscetible to insufficient or excessive fluid loading. It is therefore with care that fluids are administered and monitored. The choice of fluid is dependent on the other clinical signs of the patient such as haemodynamics. The status of the blood brain barrier is an important consideration in any patient and in the selection of fluid. However, fluids containing glucose should be avoided in these patients.

Patients with head trama or increased intracranial pressure are particularly susceptible to insufficient or excessive fluid loading. It is therefore with care that fluids are administered and monitored. The choice of fluid is dependent on the other clinical signs of the patient such as haemodynamics. The status of the [[Blood Brain Barrier - Anatomy & Physiology|blood brain barrier]] is an important consideration in any patient and in the selection of fluid. However, fluids containing glucose should be avoided in these patients.

==Literature Search==

[[File:CABI logo.jpg|left|90px]]

|full text = [http://www.cabi.org/cabdirect/FullTextPDF/2009/20093017987.pdf ''' Why did fluid therapy kill my patient?''' Schaer, M.; Gething, M.; Jones, B.; Australian Small Animal Veterinary Association, Bondi, Australia, 33rd World Small Animal Veterinary Association Congress, Dublin, Ireland, 20-24 August 2008, 2008, pp 437-439]

[http://www.cabi.org/cabdirect/FullTextPDF/2006/20063240205.pdf '''Fluid therapy - when enough is enough.''' Cooke, K.; The North American Veterinary Conference, Gainesville, USA, The North American Veterinary Conference 2003, Small Animal and Exotics. Orlando, Florida, USA, 18-22 January, 2003, 2003, pp 338]

[http://www.cabi.org/cabdirect/FullTextPDF/2009/20093017987.pdf ''' Why did fluid therapy kill my patient?''' Schaer, M.; Gething, M.; Jones, B.; Australian Small Animal Veterinary Association, Bondi, Australia, 33rd World Small Animal Veterinary Association Congress, Dublin, Ireland, 20-24 August 2008, 2008, pp 437-439 - '''Full Text Article''']

[http://www.cabi.org/cabdirect/FullTextPDF/2006/20063240205.pdf '''Fluid therapy - when enough is enough.''' Cooke, K.; The North American Veterinary Conference, Gainesville, USA, The North American Veterinary Conference 2003, Small Animal and Exotics. Orlando, Florida, USA, 18-22 January, 2003, 2003, pp 338 - '''Full Text Article''']

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