IV Fluids



IV Solutions

Solution Osm Dextrose Calories/L Na K Ca Cl Lactate
3% NS 1026 0 g/L 0 512 0 0 513 0
0.9% NS 308 0 g/L 0 154 0 0 154 0
LR 273 0 g/L 9 130 4 3 109 28
D5 W 252 50 g/L 170 0 0 0 0 0
D5 0.2 NS 320 50 g/L 170 34 0 0 34 0
D5 0.45 NS 405 50 g/L 170 77 0 0 77 0
D5 0.9 NS 560 50 g/L 170 154 0 0 154 0
D5 LR 525 50 g/L 179 130 4 2.7 109 28

1 Amp HCO3 = 50 mEq
Serum Osmo = 280-300

Source: Tarascon Pharmacopia



D5W: 5% dextrose in water

Composition: 50 grams of dextrose/L
200 calories/L
380 mOsm/L
Advantages:
  • Provides free water when serum Na and Cl are concentrated
Disadvantages:
  • Interstitial and intracellular edema caused by hyponatremia

0.9% NS: 0.9% Normal Saline

Composition: Na = 154 mEq/L
Cl = 154 mEq/L
308 mOsm/L
pH = 5.0
Advantages:
  • Increased plasma volume without changing sodium concentration or serum osmolality
Disadvantages:
  • Dilutes RBC’s and plasma proteins
  • Can cause hypernatremia and hyperchloremic metabolic acidosis if free water losses continue

Ringer's lactate

Composition: Na = 130 mEq/L
Cl = 109 mEq/L
K = 4 mEq/L
Ca = 1.4 mEq/L
Lactate = 27 mEq/L
274 mOsm/L
pH = 6.5
Advantages:
  • Isotonic, electrolytes are balanced to interstitial fluid; lactate converted to glucose and carbonic acid
  • K and Ca promote myocardial contractility
  • Ca aids clotting
  • Does not cause an increase in serum Na or Cl
Disadvantages:
  • Dilutes RBCs and plasma proteins

0.45 NS: 0.45% Hypotonic Saline

Composition: Na = 77 mEq/L
Cl = 77 mEq/L
154 mOsm/L
Advantages:
  • Rehydration or maintenance fluid without excessive serum Na or Cl
Disadvantages:
  • Interstitial and intracellular edema caused by hyponatremia

3% Hypertonic Saline

Composition: Na = 512 mEq/L
Cl = 513 mEq/L
1026 mOsm/L
Indication:
  • Symptomatic, Acute Hyponatremia
Advantages:
  • Hypertonic
  • Improves cardiac output, regional and microcirculatory blood flow
Disadvantages:
  • Excessively rapid infusion can increase Na and decrease K
  • Dysrhythmias, seizures