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25 Cards in this Set

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Normal VT
10-20 mL/kg in most domestic species
Alveolar Ventilation ( VA) =
RR x (VT– VD)
Hypercapnia: PaCO2 > 45 mmHg
§ From 45 - ˜100 mmHg it is a respiratory stimulant, § CNS stimulant and vasodilator § In excess of 100mmHg it is an anesthetic & CNS depressant
PAO2 =
[(Patm-PH20) x FiO2] - PaCO2 /0.8
“Cyanosis” requires >
5gm/dL of deoxygenated Hb
CaO2=
(Hg x %Sat x 1.34)+ (0.003 x PaO2)
Apnea Monitor
detects air flow, rate only, alarms w/apnea §continuous, auditory signal
Ventilometry
•Measures the volume of a breath (tidal volume) §simple turbine-propelled vWright’s respirometer §computerized, flow-generated
Pulse oximetry
•Detects infrared light absorption at two wavelengths, and calculates saturation of hemoglobin with O2 •Contains algorithm to subtract non-pulsatile reflectance •PaO2 = SpO2 – 30 (estimate)
MAP needed for
1.brain
2.renal
3.muscles
Cerebral and coronary (50-60 mmHg) §Renal and mesenteric (60-70 mmHg) §Muscle compartments (>70 mmHg)
pulse Not palpable lower than MAP of about
40
sphyngomanometry:
uses a cuff to occlude arterial supply to a known pressure, and define the return of flow (systolic)
oscilometric:
uses cuff, but computer detects oscillations of artery. (S, D and M)
calculated MAP=
D+1/3(S-D)
Pulse Oximetry•Accuracy
•Fair SpO2 ,<> 75-90% •Overestimation SpO2< 70% • Underestimation SpO2 > 90%
Heart Rate limits on CO
•Heart rate directly contributes to CO up to a point, then it decreases CO: §Decreasing preload (most of filling occurs in first half of diastole) §Decreasing SV §Decreasing myocardial oxygenation potential (coronary arteries fill in diastole)
•Type of murmur changes treatment during anesthesia:
§Restrictive conditions require increased filling pressures §Regurgitant conditions are aided by increasing forward flow §Failing myocardium requires contractile assistance
Central Venous Pressure
Monitoring
•Zero reference = RA •Measurement in cmH2O • with a water column •Or in mmHg with • a pressure transducer •1 mmHg = 1.36 cmH2O •CVP = 0-5 cmH2O in SA •CVP> 12 cmH2O, High •CVP < 0 cm H20, Low
BP cuff should be what % of limb circumference
30-40%
Results of cooling
Increased recovery time: mortality in some studies nDecreased metabolic rate and MAC (5% for each C°) nDecreased oxygen demand of tissues
Capillary Filtration Pressure
•Net Driving Pressure into Capillary •[(Pc-Pi) – (pp- pi)] §Pc = capillary hydrostatic pressure vArteriole approx. 35 mmHg vVenuole approx. 15 mmHg §Pi = interstitial hydrostatic pressure (0) §pp = plasma oncotic pressure (20-28 mmHg) §pi = interstitial oncotic pressure (3mmHg) •Balance » 10 mmHg fluid OUT of capillary • » 10 mmHg fluid IN to venule
Disadvantages of Colloids
•Circulatory overload •Anaphylactic reactions (incidence 0.033%) •Coagulation disorders: §‘Coating of platelets’ §Volume dilution of clotting factors vDextrans (worst) vStarches (hetastarch) vGelatins (not in use)
Assessment of Hydration
•Hydration is the presence of fluid in the interstitial space (intravascular and intracellular are far more difficult parameters to assess) §Dehydration for <3 days 80% ECF, 20% ICF §Dehydration for >3 days 60% ECF, 40% ICF •Koch and Graber
Emergency Fluid Resuscitation
•Aim: restore tissue perfusion & oxygenation •Shock fluid rates (high end value- constant re-evaluation will most likely limit these numbers): •Think ¼ blood volume to start §Blood volume: vDog 80-90 ml/kg (isotonic) vCat 60-70 ml/kg (isotonic) vColloid (dextran or hetastarch) 20ml/kg §7.5% Hypertonic saline in colloid 4ml/kg over 10min
Acute Blood Loss
•Goal: restore circulating blood volume (CBV) •Initially any fluid type will restore volume and maintain cardiac output •Volume of crystalloid must be 3 x volume of colloid for the same ­ CBV •Replace red cells or use whole blood once bleeding is under control, or when loss exceeds 20% of blood volume •What comes out must go in