Choice of fluid
Proper selection of fluid begins by determining the type of deficit and choice of fluids-Colloid, crystalloid or combination of both
Fluid
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Indications
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Isotonic saline (Normal saline, 0.9%)
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To correct metabolic acidosis, especially after vomiting
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Isotonic dextrose saline (0.18% NaCl + 4.3% Dextrose)
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Maintenance therapy, hypertonic dehydration
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Darrow’s solution (0.4% NaCl + 0.27% KCl + 0.58% Sodium lactate)
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Metabolic acidosis associated with diarrheal dehydration and potassium loss
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5% Dextrose
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Hypertonic dehydration resulting from water deprivation or heat stroke; used in emergency to provide transient alleviation of hypoglycaemia
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Compound Sodium Lactate (Hartmann’s solution or Ringer’s lactate)
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Metabolic acidosis, Replacement of losses owing to gastrointestinal dysfunction (vomiting, diarrhea), haemorrhage, burns
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Dextrose Saline (0.9% NaCl + 5% Dextrose)
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For emergency treatment of dehydration and hypoglycaemia
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Sodium bicarbonate (1.3%)
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Severe Acidosis
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Whole blood
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Replacement for blood loss in treating anaemia
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Plasma expanders
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Dextran
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Effective in restoration of blood volume in cases of hemorrhage or shock.
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Gelatin colloidal solution
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Hypovolemic shock, burns, blood loss and diarrhea
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Clinical Condition
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Choice of fluid
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Vomiting
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Normal Saline Dextrose Saline Ringer’s solution
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Diarrhea
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Lactated Ringer’s Darrow’s fluid (In chronic cases with K+ loss)
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Bowel obstruction
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Lactated Ringer’s (+ colloid for shock)
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Hemorrhage
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Whole blood Lactated Ringer’s Colloid
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Peritonitis
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Colloid Lactated Ringer’s
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Shock
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Dextran + Hartmann’s Ringer’s Lactate Gelatin Colloid
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Last modified: Thursday, 26 April 2012, 4:44 AM