IV fluid tonicity
|0.9% NaCl (normal saline)||isotonic|
|Lactated Ringer's solution||isotonic|
|D5W (acts as a hypotonic solution in body)||isotonic|
What is an example of an hypotonic solution?
The type of solution provides free water, sodium and chloride but does not provide calories or other electrolytes. An example of a hypotonic solution is 0.45% sodium chloride (0.45% NS), commonly called half normal saline.
Is normal saline hypertonic?
May be isotonic, hypertonic, or hypotonic. Normal Saline (0.9% NaCl), Lactated Ringer's, Hypertonic saline (3, 5, & 7.5%), Ringer's solution. O solutions: provide water that is not bound by macromolecules or organelles, free to pass through.
D5W is 5% dextrose in water is hypotonic so it moves fluid into the cells out of the circulation. D5NS is 5% dextrose in normal saline. D5W is technically isotonic, but it becomes hypotonic once in the body so it pulls fluid out of the vasculature and into the cells.
Pure water is definitely hypotonic. A saturated salt solution is definitely hypertonic. In between, depending on the cell and the salt, there will be an isotonic concentration, where everything is balanced.
5% Dextrose in water (D5W) is packaged as an isotonic carbohydrate (sugar solution) that contains glucose (sugar) as the solute. However, once D5W enters the body, the cells rapidly consume the glucose. This leaves primarily water and causes IV fluid to become hypotonic in relation to the plasma surrounding the cells.
DEXTROSE 50% Description. The term dextrose is used to describe the six-carbon sugar d-glucose, the principal form of carbohydrate used by the body. D50 is used in emergency care to treat hypoglycemia and to manage coma of unknown origin.
The following is a list of solutions by their tonicity:
- Hypertonic: D5 NaCl. D5 in Lactated ringers. D5 0.45% NaCl.
- Isotonic: 0.9% NaCl (Normal Saline) Lactated Ringers. D5W (In the bag)
- Hypotonic: D5W (in the body) 0.25% NaCl. 0.45% NaCl (half normal saline) 2.5% Dextrose.
Cells in Hypertonic Solutions. If concentrations of dissolved solutes are greater outside the cell, the concentration of water outside is correspondingly lower. As a result, water inside the cell will flow outwards to attain equilibrium, causing the cell to shrink.
This more concentrated outside solution is termed hypertonic. The less concentrated outside solution is termed hypotonic. Since distilled water has far less solute concentration than cell fluid, it is termed hypotonic.
Other than that, I know that greater than or equal to 5% Dextrose is considered hypertonic (D5NS, D5LR, D10). Albumin and highly concentrated electrolytes (Potassium, Magnesium), and also blood products, are hypertonic. here is a list of the hypertonic iv fluids and why they are used.
Keep in mind D5W 1/2NS is hypertonic for about 5 minutes or so. The dextrose is quickly metabolized in about 5 minutes leaving only .45NS, turning hypotonic. There is no such fluid as D5W/0.45NS. You either have D5W (5% dextrose is water) or you have D5 0.45ND (5% dextrose in half normal saline).
5% Dextrose in Water is a special case, though. Although it is technically isotonic, it acts upon the body as if it is hypotonic. The reason is because once the dextrose has been absorbed, there is only plain water left. Obviously, plain water without anything in it is hypotonic!
Dextrose is a form of glucose (sugar). Dextrose 5% in water is injected into a vein through an IV to replace lost fluids and provide carbohydrates to the body. Dextrose 5% in water is used to treat low blood sugar (hypoglycemia), insulin shock, or dehydration (fluid loss).
- 3% Saline.
- 5% Saline.
- 10% Dextrose in Water (D10W)
- 5% Dextrose in 0.9% Saline.
- 5% Dextrose in 0.45% saline.
- 5% Dextrose in Lactated Ringer's.
Hyponatremic (hypotonic) dehydration occurs when the lost fluid contains more sodium than the blood (loss of hypertonic fluid). Hypernatremic (hypertonic) dehydration occurs when the lost fluid contains less sodium than the blood (loss of hypotonic fluid). Relatively less sodium than water is lost.
Lactated Ringer's Injection, USP is a sterile, nonpyrogenic solution for fluid and electrolyte replenishment in single dose containers for intravenous administration. It contains no antimicrobial agents. Composition, osmolarity, pH, ionic concentration and caloric content are shown in Table 1.
D5NS (5% dextrose in normal saline), which, in addition, contains normal saline (0.90% w/v of NaCl). D5 1/2NS 5% dextrose in half amount of normal saline (0.45% w/v of NaCl).
Ringer's lactate solution (RL), also known as sodium lactate solution and Hartmann's solution, is a mixture of sodium chloride, sodium lactate, potassium chloride, and calcium chloride in water. It is used for replacing fluids and electrolytes in those who have low blood volume or low blood pressure.
D5, also known as DRD5, a subtype of dopamine receptors. A 5% dextrose solution, a type of intravenous fluid. Decamethylcyclopentasiloxane, an organosilicon compound. ATC code D05, Antipsoriatics, a subgroup of the Anatomical Therapeutic Chemical Classification System.
Once stabilization has occurred, free water deficits can be replaced either orally or intravenously. Euvolemic patients can be treated with hypotonic fluids, either orally or intravenously (ie, dextrose 5% in water solution [D5W], quarter or half isotonic sodium chloride solution), to correct free fluid deficits.