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Intravenous fluids, also known as IV Intravenous solutions, are supplemental fluids used in intravenous therapy to restore or maintain normal fluid volume and electrolyte balance when the oral route is not possible. They are used in people of all ages who are sick, injured, dehydrated from exercise or heat, or undergoing surgery.

Types of IV fluids

There are three types of IV fluids:
• Isotonic,
• Hypotonic, and
• Hypertonic.

1. Isotonic solution:

Isotonic solution are IV fluids that have a similar concentration of dissolved particles as blood. Examples of isotonic solutions are :-

0.9% Normal Saline (0.9% NaCl):

Indications: It’s most often used to increase the volume of circulating plasma. It can be used for things like: Blood transfusion, Fluid replacement for patients suffering from diabetic ketoacidosis, Metabolic alkalosis, Hypercalcaemia, Hyponatraemia.

Composition: water and 9 mg/ml of sodium chloride (NaCl)

Side effects: Febrile response, infection at the site of injection, venous thrombosis or phlebitis extending from the site of injection, extravasation, and hypovolaemia.

Lactated Ringer’s Solution (LR):

Indications: It’s used to treat: Dehydration, burn victims, Hypovolaemia resulting from third-space fluid shifts, Fluid loss in the lower gastrointestinal tract, Acute blood loss, Replacement of fluid and pH buffers

Composition: sodium(130mEq/L), chloride (109 mEq/L), potassium (4 mEq/L), calcium (3 mEq/L), lactate (28 mEq/L) and water.

Side effects: Agitation, back pain, bluish colour of the skin, burning, crawling, itching, numbness, prickling, tingling feeling, chest pain, discomfort, tightness, decreased heart rate, decreased urine output.

5% Dextrose in Water (D5W):

Indications: Raise your total fluid volume, Rehydration, Hypernatraemia (an electrolyte problem caused by a decrease in total body water relative to electrolyte content).

Composition: 50% dextrose, water.

Side effects: bluish colour, changes in skin colour, fast or slow heartbeat, Headache, pain, redness, pale skin, or infection at the site of injection, rapid breathing.


2. Hypotonic Solution:

Hypotonic solutions have a lower concentration of dissolved solutes than blood. An example of a hypotonic IV solution are :-

0.45% Sodium Chloride (0.45% NaCl):

Indications: Raising your overall fluid volume, water replacement, Sodium chloride depletion, Gastric fluid loss, DKA after normal saline and before dextrose infusions.

Composition: 77 mEq/L of Na and Cl and water.

Side effects: Redness, pain, or swelling at the injection site may occur, fast heartbeat, fever, rash, joint pain, or shortness of breath.

5% Dextrose in Water (D2.5W):

Indications: Raise your total fluid volume, Rehydration, Hypernatraemia (an electrolyte problem caused by a decrease in total body water relative to electrolyte content).

Composition: 50% dextrose, water.

Side effects: bluish colour, changes in skin colour, fast or slow heartbeat, Headache, pain, redness, pale skin, or infection at the site of injection, rapid breathing.


3. Hypertonic solution:

Hypertonic solutions have a higher concentration of dissolved particles than blood. An example of hypertonic IV solution are :-

3% Sodium Chloride (3% NaCl):

Indications: severe hyponatraemic encephalopathy, traumatic brain injury, and cerebral edema.

Composition: NaCl 30 g, and water

Side effects: injection site reactions (pain, swelling, redness), Hypotension (low blood pressure), Fever, Tremors, Chills.

5% Dextrose and 0.45% Sodium Chloride (D50.45% NaCl)

Indications: Dehydration, to treat severe hyponatraemia and cerebral edema.

Composition: dextrose, hydrous 5 g and sodium chloride 0.45 g in water.

Side effects: febrile response, infection at the site of injection, venous thrombosis or phlebitis extending from the site of injection, extravasation and hypovolaemia.

5% Dextrose and Lactated Ringer’s (D5LR):

Indications: Temporary treatment of circulatory insufficiency, but only if other plasma expanders are unavailable, Hypotonic dehydration, Addisonian crisis (a potentially life-threatening condition resulting from acute insufficiency of adrenal hormones), Syndrome of inappropriate antidiuretic hormone/SIADH.

Composition: 5 g Dextrose, 600 mg Sodium Chloride, 310 mg Sodium Lactate and water.

Side effects: abdominal pain, swelling of the face, arms, hands, lower legs, or feet, blurry vision, body aches, chills, confusion, cough, little or no urination, dizziness,

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