Emergency Medicine Book

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Intravenous Fluid

Aka: Intravenous Fluid, Fluid Replacement, Hypotonic Saline, Hypertonic Saline, Saline Solution
  1. See Also
    1. Isotonic Saline
  2. Preparations: Hypotonic Solutions
    1. Dextrose in Water (D5W)
      1. Osmolality: 252 mOsm/L
      2. Glucose: 50 g/L
      3. Contains no Sodium or chloride
      4. Primarily used to deliver intravenous medications in small volume fluid infusions (<100 ml)
    2. Half Normal Saline (0.45 NaCl or 1/2NS)
      1. Osmolality: 154 mOsm/L
      2. Sodium: 77 mEq/L (with equivalent chloride)
      3. Equivalent of administering half free water and half isotonic saline
      4. Consider in Hypernatremia with volume depletion
      5. Risk of Hyponatremia
        1. Prolonged use
        2. Impaired water excretion (e.g. GFR <20%, CHF, Cirrhosis, Nephrosis)
  3. Preparations: Isotonic Solutions
    1. General
      1. NS or LR is the typical replacement in most volume depleted cases
      2. LR may be preferred as more physiologic (pH neutral) compared with the acidic NS
      3. Hypovolemia due to Hemorrhage should be replaced with blood (as indicated)
    2. Normal Saline (0.9% NaCl or NS)
      1. Osmolality: 308 mOsm/L
      2. Sodium: 154 mEq/L (with equivalent chloride)
      3. pH: 5-6
    3. Lactated Ringers (LR)
      1. Osmolality: 272 mOsm/L
      2. Sodium: 130 mEq/L
      3. Chloride: 109 mEq/L
      4. Lactate: 28 mEq/L (buffer)
      5. Also contains Potassium (4 mEq/L) and calcium (3 mEq/L)
      6. pH: 6.5
  4. Preparations: Hypertonic Solutions
    1. Hypertonic Saline (3% NaCl)
      1. Osmolality: 1026 mOsm/L
      2. Sodium: 513 mEq/L (with equivalent chloride)
      3. pH: 5
      4. Exercise caution and dose very carefully (risk of Central Pontine Myelinolysis)
      5. Indications
        1. Severe symptomatic Hyponatremia
        2. Severe cerebral edema with risk of Herniation (Traumatic Brain Injury)
  5. References
    1. Loflin (2015) Crit Dec Emerg Med 29(9): 11-18
    2. Marino (2014) The ICU Book, Wolters Kluwer, Philadelphia, p. 217-37
    3. Preston (2011) Acid-Base, Fluids and Electrolytes, Medmaster, Miami, p. 30-4

Saline Solution (C0036082)

Definition (NCI_NCI-GLOSS) A solution of salt and water.
Definition (NCI) A solution of salt and water. Saline usually refers to normal or physiological saline, which is an aqueous solution containing 0.9% sodium chloride.
Definition (CSP) any aqueous salt solution; usually means normal or physiological saline, which is 0.9% sodium chloride, and is used as a base for culture media and buffers, and as an injection vehicle or control.
Concepts Substance (T167)
MSH D012965
SnomedCT 373757009, 256557003, 32841004
LNC LP31577-7
English NaCl - Sodium chloride solutn, Sodium Chloride 0.9%, Saline, SALINE SOLUTION, saline solution, saline solutions, sodium chloride solution, chloride sodium solution, Saline Solution, Sodium Chloride Solution, saline, NaCl - Sodium chloride solution, Sodium chloride solution, Sodium chloride solution (product), Sodium chloride solution (substance)
Spanish solución salina, solución de NaCl, solución de cloruro de sodio (producto), solución de cloruro de sodio (sustancia), solución de cloruro de sodio
French Solution saline
German Salz
Italian Soluzione salina
Norwegian Saltoppløsning
Czech solný roztok
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Saline Solution, Hypertonic (C0036085)

Definition (NCI) Any solution of sodium chloride (NaCl) in water with a concentration of NaCl higher than that found in physiological saline (0.9% w/v). When administered in vivo, hypertonic saline (HTS) exhibits several physiological effects beneficial to cerebral injury including: 1) osmotic and vasoregulatory - by promoting the flow of excess water from cerebral tissue to the blood via osmosis and decreasing edema in the vascular endothelium of injured tissues, thus lowering vascular resistance and allowing more blood flow; 2) hemodynamic - by effectively expanding plasma volume; 3) immunomodulatory - by preventing leukocytes from becoming activated and adhering to injured neurons and; 4) neurochemical - by counteracting detrimental excitatory amino acids through the normalization of neuronal cell membranes and by restoration of normal electrolyte and neurotransmitter levels in brain cells, and normal cell volumes.
Definition (MSH) Hypertonic sodium chloride solution. A solution having an osmotic pressure greater than that of physiologic salt solution (0.9 g NaCl in 100 ml purified water).
Definition (PDQ) Any solution of sodium chloride (NaCl) in water with a concentration of NaCl higher than physiologic (0.9% w/v). When administered in vivo, hypertonic saline (HTS) exhbits several physiological effects beneficial to cerebral injury including: 1) osmotic and vasoregulatory - by promoting the flow of excess water from cerebral tissue to the blood via osmosis and decreasing edema in the vascular endothelium of injured tissues, thus lowering vascular resistance and allowing more blood flow; 2) hemodymanic - by effectively expanding plasma volume; 3) immunomodulatory - by preventing leukocytes from becoming activated and adhering to injured neurons and; 4) neurochemical - by counteracting detrimental excitatory amino acids through the normalization of neuronal cell membranes and by restoration of normal electrolyte and neurotransmitter levels in brain cells, and normal cell volumes. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=467928&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=467928&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C60814" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Inorganic Chemical (T197)
MSH D012462
SnomedCT 51103004, 373766008
English Hypertonic Saline Solution, Hypertonic Saline Solutions, Hypertonic Solution, Saline, Hypertonic Solutions, Saline, Saline Hypertonic Solution, Saline Hypertonic Solutions, Saline Solutions, Hypertonic, Sodium Chloride Solution, Hypertonic, Sodium Chloride Solutions, Hypertonic, Solution, Hypertonic Saline, Solution, Saline Hypertonic, Solutions, Hypertonic Saline, Solutions, Saline Hypertonic, HTS, hypertonic saline, Saline Solution, Hypertonic, SALINE SOL HYPERTONIC, SODIUM CHLORIDE SOL HYPERTONIC, HYPERTONIC SOL SALINE, HYPERTONIC SALINE SOL, Hypertonic Saline, Sodium Chloride Hypertonic, Sodium Chloride, Hypertonic, hypertonic sodium chloride, hypertonic saline solution, sodium chloride, hypertonic, Hypertonic sodium chloride, Hypertonic saline, Hypertonic saline (product), Hypertonic saline (substance)
Swedish Saltlösning, hyperton
Czech sůl - hypertonický roztok
Finnish Hypertoniset suolaliuokset
Russian SOLEVOI RASTVOR GIPERTONICHESKII, GIPERTONICHESKII SOLEVOI RASTVOR, NATRIIA KHLORISTOGO RASTVOR GIPERTONICHESKII, GIPERTONICHESKII RASTVOR SOLEVOI, ГИПЕРТОНИЧЕСКИЙ РАСТВОР СОЛЕВОЙ, ГИПЕРТОНИЧЕСКИЙ СОЛЕВОЙ РАСТВОР, НАТРИЯ ХЛОРИСТОГО РАСТВОР ГИПЕРТОНИЧЕСКИЙ, СОЛЕВОЙ РАСТВОР ГИПЕРТОНИЧЕСКИЙ
Italian Soluzione ipertonica di cloruro di sodio, Soluzione salina ipertonica, Soluzioni ipertoniche di cloruro di sodio, Soluzioni saline ipertoniche
Polish Roztwór soli hipertoniczny, Roztwór chlorku sodu hipertoniczny
Japanese 高張塩化ナトリウム溶液, 高張食塩水, 食塩高張溶液, 高張食塩液, 高張食塩溶液, 食塩水-高張
Norwegian Saltvannsoppløsning, hyperton, Hypertonisk natriumkloridoppløsning, Hyperton saltvannsoppløsning, Hypertonisk saltvannsoppløsning, Natriumkloridoppløsning, hyperton, Hyperton natriumkloridoppløsning, Natriumkloridoppløsning, hypertonisk, Saltvannsoppløsning, hypertonisk
Spanish cloruro de sodio hipertónico, solución salina hipertónica (producto), solución salina hipertónica (sustancia), solución salina hipertónica, Solución Hipertónica de Cloruro de Sodio, Solución Salina Hipertónica
French Solution saline hypertonique
German Hypertone Lösung, Salz-, Hypertone Salzlösung, Kochsalzlösung, hypertone, Natriumchloridlösung, hypertone, Salzlösung, hypertone
Portuguese Solução Hipertônica de Cloreto de Sódio, Solução Salina Hipertônica
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Fluid replacement (C0521302)

Concepts Therapeutic or Preventive Procedure (T061)
SnomedCT 78534001
Italian Reintegrazione di liquidi, Reintegrazione di liquidi NAS, Reintegrazione volumetrica
Dutch vochtsubstitutie NAO, volumesubstitutie, vochtsubstitutie
French Réhydratation SAI, Remplacement du volume circulant, Réhydratation
German Fluessigkeitssubstitution NNB, Volumensubstitution, Fluessigkeitssubstitution
Portuguese Reidratação NE, Reposição de volume, Reidratação
Spanish Reposición de líquidos NEOM, Reposición de volumen, reposición de líquidos corporales (procedimiento), reposición de líquidos corporales, reposición de líquidos, Reposición de líquidos
Japanese 補液, 補液NOS, ホエキNOS, ホエキ, 循環血液量補充, ジュンカンケツエキリョウホジュウ
Czech Náhrada tekutin, Náhrada tekutin NOS, Náhrada objemu tekutin
English Fluid replacement NOS, fluid replacement, fluids replacement, body fluid replacement, Volume replacement, Body fluid replacement, Body fluid replacement (procedure), Fluid replacement
Hungarian Folyadékpótlás k.m.n., Folyadékpótlás, Volumen pótlás
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Intravenous fluid (C1289919)

Definition (NCI) A sterile liquid preparation infused into a vein. IV fluid is prescribed as a replacement of fluid, electrolytes, calories, vitamins, and other nutritional substances. In addition, IV fluids are used to administer blood products and medications such as chemotherapy. Examples of IV fluids include Normal Saline, Ringers Solution, and Lactated Ringers Solution. (NCI)
Concepts Substance (T167)
SnomedCT 118431008
Spanish líquido para administración intravenosa, Fluidoterapia intravenosa, líquido IV, líquido endovenoso, líquido intravenoso, líquido para administración intravenosa (sustancia)
English Fluid for intravenous administration, Intravenous fluids, intravenous (IV) fluid, intravenous fluid, Fluid for intravenous administration (substance), IV fluid, Intravenous fluid, Intravenous Fluid, IV Fluid
Italian Liquidi intravenosi
French Liquides intraveineux
Dutch intraveneuze vloeistoffen
German intravenoese Fluessigkeitsgabe
Portuguese Fluidos intravenosos
Japanese ジョウミャクナイホエキ, 静脈内補液
Czech Intravenózní tekutiny
Hungarian Intravénás folyadékok
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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