Intravenous Fluid Comparison

Type Solution Uses Special Considerations

Dextrose 5% in water Fluid loss Use cautiously in renal and cardiac patients
Isotonic (D5W) Dehydration Can cause fluid overload
Hypernatremia
Shock Can lead to overload
0.9% sodium chloride Hyponatremia Use with caution in patients with heart failure or
Isotonic (Normal Saline) Blood transfusions edema
(NaCl) Resuscitation
Fluid challenges
DKA
Dehydration Contains potassium, dont use with renal failure
Burns patients
Isotonic Lactated Ringers Lower GI fluid loss Dont use with liver disease, cant metabolize lactate
(LR) Acute blood loss
Hypovolemia due to
third spacing
Water replacement Use with caution
Hypotonic 0.45% sodium chloride DKA May cause cardiovascular collapse or increased
(1/2 normal saline) Gastric fluid loss intracranial pressure
from NG or vomiting Dont use with liver disease, trauma, or burns
Hypertonic Dextrose 5% in Later in DKA Use only when blood sugar falls below 250 mg/dL
normal saline treatment
Temporary treatment Dont use n cardiac or renal patients
Hypertonic Dextrose 5% in normal for shock if plasma
saline expanders arent
available
Addisons crisis
Water replacement Monitor blood sugar levels
Hypertonic Dextrose 10% in water Conditions where
some nutrition with
glucose is required