Francis Pierre O.
Glinoga for hyperglycemic conditions like
BSN 4C – Blessed Frederick
TYPES OF INTRAVENOUS
FLUID
ISOTONIC SOLUTION
Close to the same osmolarity as
serum. They stay inside the
intravascular compartment, thus
expanding it. Can be helpful in
hypotensive or hypovolemic patients.
Can be harmful. There is a risk of fluid
overloading, especially in patients with
CHF and hypertension.
Examples: Lactated Ringer's (LR), NS
(normal saline, or 0.9% saline in
water).
Isotonic fluids contain an
approximately equal number of
molecules (blue dots) as serum so the
fluid stays within the intravascular
space.
Remember that fluid flows from an
area of lower concentration of
molecules to an area of high
concentration of molecules (osmosis)
to achieve equilibrium (fluid balance).
HYPOTONIC SOLUTION
Have less osmolarity than serum (i.e.,
it has less sodium ion concentration
than serum). It dilutes the serum,
which decreases serum osmolarity.
Water is then pulled from the vascular
compartment into the interstitial fluid
compartment. Then, as the interstitial
fluid is diluted, its osmolarity
decreases which draws water into the
adjacent cells.
Can be helpful when cells are
dehydrated such as a dialysis patient
on diuretic therapy. May also be used
diabetic ketoacidosis, in which high
serum glucose levels draw fluid out of
the cells and into the vascular and
interstitial compartments.
Can be dangerous to use because of
the sudden fluid shift from the
intravascular space to the cells. This
can cause cardiovascular collapse and
increased intracranial pressure (ICP) in
some patients.
Example: .45% NaCl, 2.5% dextrose
Hypotonic fluids contain a lower
number ofmolecu les than serum so
the fluid shifts from the intravascular
space to the interstitial space
(represented by the green arrows).
This decreases the interstitial space
osmolarity (because of the increase of
fluid and constant number of
molecules within it) which then causes
fluid to move into the cells. Note that
the green arrows represent
fluid movement, not molecule
movement.
HYPERTONIC SOLUTION
Have a higher osmolarity than serum.
Pulls fluid and electrolytes from the
intracellular and interstitial
compartments into the intravascular
compartment. Can help stabilize blood
pressure, increase urine
output, and reduce edema.
Rarely used in the prehospital setting.
Care must be taken with their use.
Dangerous inthe setting of cell
dehydration.
Examples: D5W.45% NaCl, D5WLR,
D5W