Vascular Access and Fluid Therapy in Patients in Shock

Fluid resuscitation is indicated in most patients in shock. Two major exceptions include the heart failure patient, who may actually be hypervolemic, and the cardiac arrest patient that was known to have been euvolemic prior to the arrest. Congestive heart failure patients that have been receiving diuretics or have been vomiting may present in a hypovolemic state.

There is a wide range of fluids available for treating small animal patients. Each fluid was designed with a specific purpose in mind and understanding the composition
of the fluid is essential to understanding the indications and both potential and
real advantages and disadvantages of each. The choice of a fluid depends to a large extent on the underlying disease process that is being treated and the abnormalities
in the fluid dynamics in the disease process. A patient that is dehydrated has a loss of interstitial volume, which will need to be treated very differently than the patient that is hypovolemic and is not perfusing its tissues adequately. It should be kept in mind that almost all fluids were designed for use in human beings and the effects in small animal patients may be different than what was intended when the fluid was developed. The label on the fluid should always be read to ensure the veterinarian and the nursing staff understand fully what is actually being infused into a patient. […]