Fluids during surgery

RE: Fluids during surgery

Taku — Fri, 17 Jun 2016 12:07:21 GMT

Thanks for the replies guys all your info has been very helpful... I am now looking into CPDs or any online small courses , is they any you guys can suggest ??

Once again thanks lots

RE: Fluids during surgery

James Colver Cert. Ed, RVN — Thu, 16 Jun 2016 13:04:59 GMT

Looking at ways of decreasing inhalation agent to help keep BP up - i.e. multimodal analgesia!!!

RE: Fluids during surgery

Siobhan Steven — Thu, 16 Jun 2016 12:56:34 GMT

Hi Taku, to not complicate things too much, firstly you need to ascertain why the BP is dropping, it can be due to cerdiac output, basically heart rate, or volume issues for example hypovoleamia due to a splenic rupture, or vasodilation for example, due to using ACP or to high MAC with your volatile agent (Iso or Sevo). Fluid therapy can be used for volume issues and in conjunction with a negative inotrope with vasodilation, but like I say, you need to figure out what the issue is, not just crank up the fluids. 'Indications' would be what type of fluid loss or support is indicated, whether a blood transfusion is needed or whether Hartmanns will suffice, mannitol may be indicated when intracranial pressure increases are indicated and a cushings response is detected...it is quite a complex 'science'....Drug protocols that we use are anticholenergics for bradycardia (atropine/glycopyrolate), negative inotropes are dopamine/dobutamine, medetomidine will usually cause bradycardia with a reflex hypotension. Opioids have their dose dependant side effects. I found it's best to do some CPD and increase my basic knowledge and then expand it in clinic, luckily I work in anaesthesia with specialists now so it's a big help.

RE: Fluids during surgery

Taku — Tue, 12 Apr 2016 05:57:16 GMT

Hey Susanna

Thanks a lot for the post ,I do agree with fluids can be detrimental especially in cats.

Which drug protocols do you use to help with BP problems and do you use fluids in some of your surgical patients?

If so what's your fluid indication criteria?

RE: Fluids during surgery

Taku — Tue, 12 Apr 2016 05:51:20 GMT

Hi Vicky

Thanks a lot for valuable infor this article is pretty good.

Yah we do use BP machine and sometimes it keeps dropping.

RE: Fluids during surgery

Susanna Taylor — Mon, 11 Apr 2016 13:56:04 GMT

Agree with Vicky's post. That article is a great summary of the best EVM available.

The recommendations from that review are 3ml/kg/hr for cats as standard and 5ml/kg/hr for dogs. The key point is that there is no evidence behind 10ml/kg/hr and in fact this may be detrimental, especially in cats.

It can be v hard changing peoples perceptions about GA fluids, especially if you struggle with blood pressures. I would suggest, show the literature around, lower rates gradually over a few months and look at drug protocols if necc to improve BPs

RE: Fluids during surgery

Vicky Ford-Fennah — Mon, 11 Apr 2016 08:38:58 GMT

Hi,

Have a look at this review article, it's a really good paper from the American animal hospital association and has some good guidelines. Some of the fluids they talk about aren't available in the uk but as a general rule Hartmanns should be used.

http://www.catvets.com/public/PDFs/PracticeGuidelines/FluidTherapyGLS.pdf

Do you monitor blood pressure?

Vicky