Guide to IV Fluids Why Are You Giving IV Fluids? 1. Hypovolemic - Which: Use NS First But

IV Fluids

Guide to IV Fluids
Why are you giving IV fluids?
1. Hypovolemic
- which: use NS first but if > 3-4L, switch to LR due to risk of expansion acidosis
- why: closest to isotonic (LR slightly hypotonic at 273<290; NS slightly hypertonic at 308>290) for rapid expansion
- IF working liver and lungs, LR provides lactate that can accept a proton and buffer against acidosis
2. Hypervolemic: DON'T give fluidsunless hypotensive, septic, etc.
3. Pre-procedure/NPO
- which: D5 1/2NS at 100cc/hr
- why:provide calories to prevent protein breakdown, 1/2NS to prevent being hypertonic
- can estimate IVF rate by weight in kg + 40
4. Elective admission: no fluids unless necessary