One of the easiest to perform is a skin tent test to check the turgor, or moisture level, of the skin. Hydration status can be assessed using several simple tests. 5 Dehydration must not be confused with hypovolemia: dehydration describes a water deficit in the interstitial and intracellular compartments, whereas hypovolemia describes a loss of fluid in the intravascular space. Any patient determined to be more than 10% dehydrated is considered severely dehydrated 4 and requires immediate fluid resuscitation and careful monitoring. If severe, dehydration can be detected in derangements in forward perfusion parameters 1 as well as by the tests listed below. Loss of fluid from the intracellular and interstitial compartments leads to dehydration. Restoring perfusion and, subsequently, oxygen and nutrient delivery to tissues is crucial to survival in these patients. If allowed to persist, this imbalance can lead to acute decompensation and death. Shock is defined as the critical imbalance between the delivery of oxygen and nutrients (carried by blood) to tissues and the tissues’ demand for these components. Patients that cannot adequately perfuse their tissues require immediate intervention with fluid therapy to restore perfusion and correct shock. The veterinary staff must assess whether the patient is perfusing its tissues well, check for dehydration, and evaluate losses from any of the fluid compartments.
#Body fluid compartments usmle video full#
The first step in determining whether a patient needs fluid therapy is a full physical examination, including collection of a complete history. Veterinary professionals provide fluid therapy to patients for many reasons, including correction of dehydration, expansion and support of intravascular volume, correction of electrolyte disturbances, and encouragement of appropriate redistribution of fluids that may be in the wrong compartment (e.g., peritoneal effusion). This knowledge helps guide both fluid choice and the method used to administer fluid therapy. When providing fluid support to patients, technicians must keep in mind which compartment needs to be replenished or what derangement needs to be corrected.
In addition to losses, fluid can and does move between compartments in a dynamic and ever-changing fashion. In the case of hemorrhage, for example, fluid is lost from the intravascular space (i.e., plasma) but also from the ICF in the cells lost (e.g., red blood cells, white blood cells). The body is considered a closed system, meaning that any fluid lost must come from one of the compartments listed above.
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