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Practical fluid therapy
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The main purpose of fluid therapy is restoring circulating volume in cases dehydration or hypovolaemia. This will in turn improve cardiac output and increase oxygen delivery to tissues. In addition, fluid therapy is used to correct metabolic derangements such as electrolyte imbalances or acid-base disturbances.
There are two main types of fluids:
Crystalloid solutions consist of electrolytes in water and can be isotonic, hypertonic or hypotonic. Isotonic crystalloids have the same osmolality as plasma and can be administered in large volumes. Hypertonic fluids are used to restore circulating volume rapidly by drawing water from the intracellular fluid. Hypotonic fluids are typically only used to correct plasma hypertonicity.
Colloids are solutions containing larger molecules, allowing them to persist longer in the circulation whilst exerting osmotic pressure to draw water into the vascular space in a similar way to hypertonic crystalloids. Examples of colloids include gelatines, starches or plasma.
Two main routes of administration of fluids are used: intravenous and enteral. The administration of fluids via the intravenous route is mainly done through the jugular vein but other options are available. The enteral route, via a nasogastric or naso-oesophageal tube provides an affordable alternative in cases where the intestinal function is unaffected. More recently, administration of fluids per rectum has been described.
Any fluid therapy plan must replace the fluid deficit present (as determined by clinical signs or laboratory markers), provide the daily maintenance requirements and consider any potential ongoing loses (such as reflux or diarrhoea).
I graduated from the Complutense University of Madrid in 2001 followed by 6 years in mixed practice in East Yorkshire, UK. In 2008 I moved to the University of Liverpool where I completed an ECEIM residency in Equine Internal Medicine. I am a European Specialist in Equine Internal Medicine since 2011 and currently work as a senior lecturer at the University of Liverpool. In 2021 I completed a PhD on the Epidemiology of Uveitis. I am interested in all aspects of Equine Medicine but have a particular interest in ophthalmology, oncology, neurology and gastrointestinal medicine.
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