What electrolyte abnormality is associated with Albumin?
Hypocalcemia - Albumin binds calcium
Albumin binds calcium
Why is there an FDA black box warning on synthetic colloids?
Risk of renal injury
What is the difference in terms of where volume is added generally with crystalloids vs colloids?
Crystalloids - expand ECF
Colloids - only expand plasma volume
How long do crystalloids increase plasma volume?
30-60 min
How do crystalloids impact inflammation?
They increase inflammatory mediators
How does Albumin impact inflammation?
Decreases inflammation
How long do colloids increase plasma volume?
3-6 hours
How do colloids decrease edema?
Due to longer intravascular half-life
Which colloid has the highest risk of coagulopathy?
Dextran>Hetastarch>Hextend
How does Hetastarch impact clotting?
Decreases Factor VIII & von Willebrand Factor
Causes platelet dysfunction
How will Hetastarch impact the TEG?
Will look hypocoagulable
Decreases MA
What are contraindications to Hetastarch?
Sepsis
AKI
Cardiopulmonary bypass
Bleeding
What is a manifestation of nephrotoxicity you may see with Hetastarch?
Severe pruritis
What is the max dose for synthetic colloids?
20mL/kg
How does Dextran impact blood transfusions?
Impairs crossmatch
Which synthetic colloid has the highest risk of anaphylactic/anaphylactoid reaction?
Dextran
What would be the best synthetic colloid for use during vascular surgery and why?
Dextran
Decreases blood viscosity
Improves microvascular flow
Why is dosing vital with synthetic colloids?
Renal impacts
Dose-dependent coagulopathy due to hemodilution
Which synthetic colloid is not associated with coagulopathy?
Voluven
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Acid-Base10
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CCAR #3125
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Random NMB / Reversal Pharm Stuff21
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SNS6
