Five times maintenance...

Re: Five times maintenance...

Claire Cameron — Sun, 06 Dec 2009 21:46:02 GMT

The existing deficit is that which has been lost prior to examination. This must be estimated by evaluating the patient's history, making a physical examination and using laboratory aids.

Maintenance therapy is to replace normal losses occurring via urine, faeces, respiratory tract and skin. As a general rule maintenance therapy requires 50mls/kg bodyweight/day. Continuing losses during a disease period should be estimated whenever possible, i.e. quantity of vomit, diarrhoea or blood loss.

The clinical response of the animal rather than formulae or equations should be used to guide fluid therapy. The intravenous route of administration is preferred. Indwelling venous catheters offer significant advantage in intravenous fluid therapy. Subcutaneous administration may be used for isotonic and non-irritating solutions.

The rate of administration should be considered with each individual patient. The aim should be to correct about half of the calculated deficit in the first 1–2 hours. As a general rule the following formula is the maximum satisfactory rate (less where cardiovascular or pulmonary disease exists).

Maximum rate=Body wt (kg)×90=mls fluid per hour.

This rate should be slowed after the first hour and considerably slowed if no urine flow is established. Signs of over rapid administration include restlessness, moist lung sounds, tachycardia, tachypnoea, nasal discharge, coughing, vomiting and diarrhoea.

Once these losses have been replaced, it should be substituted by Aqupharm No. 18 to avoid the administration of an excess of sodium ions. Additional oral potassium supplements may be required with protracted use

http://www.noahcompendium.co.uk/Animalcare_Limited/documents/S3996.html

Re: Five times maintenance...

Saskia Quinn — Sun, 06 Dec 2009 19:41:45 GMT

If memory serves me correctly, I think we were taught to give shock treatment for approx 1 hour. This would depend on how the patient responds of course. Each case is individual.

Re: Five times maintenance...

Rachel Jayne — Sun, 06 Dec 2009 19:13:27 GMT

I think the aqupharm poster suggests for half an hour

Re: Five times maintenance...

laurad — Sun, 06 Dec 2009 19:08:52 GMT

another thing to look out for is how much urine is being produced when a patient is placed on fluids. I hope your patient is on the road to recovery by now

Re: Five times maintenance...

hobbits — Sun, 06 Dec 2009 13:25:17 GMT

until it works! monitor closely for overinfusion and monitor for improvement. if no improvement and you are sure hypovolaemia is the cause then increase it. if parameters return to normal/near normal start to reduce it.