❇️ IV Fluids & When NOT to Use Them:

 

❇️ IV Fluids & When NOT to Use Them:

Intravenosa fluids are pharmacologic agents and must be prescribed with the same caution as drugs. Incorrect fluid choice or inappropriate administration can worsen morbidity.

Common IV Fluids

→ Normal Saline (0.9% NaCl)

→ Isotonic crystalloid used for hypovolemia and shock

→ High chloride content may cause hyperchloremic metabolic acidosis

→ Ringer’s Lactate (RL)

→ Balanced crystalloid containing Na⁺, K⁺, Ca²⁺, Cl⁻, and lactate

→ Preferred in trauma and surgical patients

→ Avoid in severe liver failure

→ Dextrose 5% in Water (D5W)

→ Becomes hypotonic after metabolism

→ Used for maintenance fluids and hypoglycemia

→ Contraindicated in raised intracranial pressure

→ Dextrose Normal Saline (DNS)

→ Provides both calories and intravascular volume

→ Used for maintenance in selected patients

→ Albumin 5%

→ Colloid used for volume expansion

→ Indicated in hypoalbuminemia and selected ICU cases

When NOT to Use IV Fluids / Use With Caution

→ Heart failure

→ Risk of fluid overload and pulmonary edema

→ Renal failure with oliguria or fluid overload

→ Risk of worsening volume overload

→ Raised intracranial pressure

→ Avoid hypotonic fluids due to risk of cerebral edema

→ Severe hyponatremia

→ Rapid correction increases risk of osmotic demyelination syndrome

→ Uncontrolled diabetes mellitus

→ Avoid dextrose-containing fluids unless specifically indicated

→ Hyperchloremic metabolic acidosis

→ Excess normal saline worsens acidosis