Professional Documents
Culture Documents
Presented By
WAFAA ABDELSALAM
ASS LECTURER OF ANEATHESIA AND ICU
KAFR ELSHEIKH UNIVERSITY
INTRAVENOUS THERAPY OR IV
THERAPY
fluids.
BODY
COMPARTMENTS
INTRACELLULAR
EXTRACELLULA
R
EXTRACELLULAR
INTRAVASCULA
R
INTERSTITIAL
TRANSCELLULA
R
TYPES OF IV FLUIDS:
CRYSTALLOIDS
COLLOIDS
CRYSTALLOIDS:
Isotonic, Hypotonic and Hypertonic
ISOTONIC
Osmolalit
y of 250375
mOsm/L
No
shifting
of fluid
Only
serves to
increase
the ECF
HYPOTONIC
Osmolarity of
>250 mOsm/L
Shifting of fluid
from
intravascular
to both
intracellular
and interstitial
spaces
Hydrate the
cells causing
them to swell.
HYPERTONIC
Osmolarity of
375 mOsm/L
or higher
Water moves
out of the
intracellular
space
increasing
ECF( volume
expanders)
Dehydrate the
cells causing
shrinkage.
ISOTONIC
HYPOTONIC
HYPERTONIC
0.9% Nacl
0.45% Nacl
3% Nacl
Lactated
Ringer
0.33% Nacl
5% Nacl
0.2 % Nacl
3%Nacl or
5% Nacl
+D/W
Ringers
Solution
5% Dextrose
in water
2.5%
Dextrose
water
>5% D/W
example,D10
W
ISOTONIC SOLUTIONS
INDICATIONS:
Isotonic solutions contain electrolytes
such as Nacl,KCL,Cacl and sodium
lactate.
Indicated in the treatment of vascular
dehydration, replaces sodium and
chloride.
5%D/W is isotonic when infused but
becomes hypotonic when dextrose has
been metabolized.
Use cautiously in patients who are
fluid-overloaded or who would be
compromised if vasscular volume
would increase such as renal and
Lactated
Ringers
Dehydration
Burns
GI tract fluid loss
Acute blood loss
Hypovolemia
Contains potassium,
can cause
hyperkalemia in renal
patients.
Patients with liver
disease cannot
metabolize lactate.
Lactate is converted
into bicarb by liver.
D5W
Fluid loss and
dehydration
Hypernatremia
Solution becomes
hypotonic when
dextrose is
metabolized
Do not use for
resuscitation
Use cautiously in
renal and cardiac
patients
HYPOTONIC SOLUTIONS
INDICATIONS (<250mOsm/L)
0.45% Nacl normal
saline
Treatment of hypertonic dehydration.
Gastric fluid loss
Cellular dehydration from excessive diuresis
Slow rehydration
SPECIAL CONSIDERATIONS:
Do not give to patients at risk for ICP
Not for rapid rehydration
Electrolyte disturbances can occur
HYPERTONIC
SOLUTIONS INDICATIONS
5%Dextrose in 0.9%
Nacl
( D5NS)
USES:
Heat related
disorders
Fresh water
drowning
Peritonitis
SPECIAL
CONSIDERATION
S:
Avoid in impaired
cardiac or renal
function.
Draw blood
before
5%Dextrose in
Lactated Ringers
( D5LR)
5% Dextrose in
0.45% Nacl
(D51/2NS)
USES:
Hypovolemic
shock
Hemorrhagic
shock
Certain cases of
acidosis
USES:
Heat exhaustion
Diabetic disorders
TKO solution in
patients with renal
or cardiac
dysfunction
SPECIAL
CONSIDERATIO
NS:
SPECIAL
CONSIDERATION
S:
Avoid in patients
with cardiac or
renal dysfunction.
CAUTION :
HYPOKALAEMIA
HYPERKALAEMIA
PROTOCOL:
REFERENCES:
Andrew K Hilton and et al,MJA(Medical journal of Australia)