Diferent types of IV fluids are explained

1. Welcome
to
ethical committee
TYPES OF IV FLUIDS
-By
Ms. Nikita Barwal
Assistant professor
Dr. PDNI, AMRAVATI
<<

2. Types of Intra Venous Fluid

3. Can You Imagine life without water?
Of course not, because water is essential to sustain life.
Likewise, body fluids are vital to maintain normal body
functioning. Total body fluid (TBW), accounts for approximately
60% of total body weight (this can be 70% or higher in a
newborn down to 50–55% in a mature woman). Total Body Fluid
can be divided into Intracellular and Extracellular Fluid.

4. INTRA VENOUS FLUID
Introduction
IV fluids are specially formulated liquids that are injected into a vein to
prevent or treat dehydration. They are used in people of all ages who are
sick, injured, dehydrated from exercise or heat, or undergoing surgery.
Intravenous rehydration is a simple, safe and common procedure with a
low risk of complications.

5. Intra-venous fluid Contd…
Different types of IV fluids (Intravenous fluids) or drip helps to restore the normal
fluid volume or electrolyte balance in situations where oral therapy cannot be
effective. Various IV fluids are required in different unique situations in clinical
settings.
About 60% of an adult and 80% of a neonate body contains water. This amount varies
based on age, sex, and body mass. Different types of IV fluids move in two main
compartments.

6. 1. Intracellular Fluid
• The Intracellular fluid is the fluid contained within cells.
• 2/3 of the total body water
• Found inside the plasma membrane of the body's cells.
• This fluid exists between cells of the body and serves to help transport
nutrients, gases and wastes
• Intracellular fluid examples of electrolytes are varied and can depend on where
the cell is found in the body. By far the most important or main, electrolyte
found in intracellular fluid is potassium

7. 2.Extracellular Fluid
• The fluid outside the cells or that is not contained in cells– is divided
into that found outside the blood.
• Accounts for 1/3 of the TBW, it is found in blood, in body cavities
lined with serous membrane and in channels of brain or spinal cord.
• The extracellular fluid is composed of blood plasma, interstitial fluid
e.g: Cerebrospinal fluid, aqueous humor in the eye, joint fluid.

8. What The Fluids Do To Your Cells ?
Before we delve into types of IV fluids, we first need to cover a few basic definitions
that will help you to better understand what the bag of fluid is doing with the cells
which is present in our body.
 Osmosis
Osmosis is an important mass transport process in biology. It’s the process by which
movement of water molecules from a solution with a high concentration to low
concentration through semipermeable membrane.
Example : When we sit in the bathtub or submerge our fingers in water for a while
they got wrinkly. & that is to because of osmosis, the skin of our fingers absorb water
and get expanded or bloated.

9. Osmosis

10.  Osmotic Pressure
Osmosis is regulated by osmotic pressure, which is the pressure necessary to
prevent the inward flow of water across a membrane. This is what protects a cell
from taking in more water than it can handle, which would cause the cell to burst.
Simply put, it’s the pressure necessary to stop osmosis from occurring.

11.  Osmotic Pressure

12. The Basics of IV Fluids
Osmosis and osmotic pressure are essential players when it comes to IV fluids and
cells. In fact, IV fluids are specifically designed to create a certain reaction in cells
based on osmosis, depending on what you’re trying to achieve. Basically, whether
something flows into or out of cells has a significant impact on how our body
responds to it. So when we talk about IV fluids and IV solutions, what we’re really
discussing is how these solutions effect osmosis and osmotic pressure in cells.
IV fluids are either crystalloids or colloids. A crystalloid or colloid solution can also be
isotonic, hypotonic, or hypertonic, and that directly affects what that solution is used
for.

13. What are the types of IV fluids?
There are different kinds of IV fluids, healthcare provider will decide which type is
right for person, depending on why need to give them. The fluids used in clinical
practice are usefully classified into colloids and crystalloids.
Crystalloid solutions:
These are the most common types of IV fluid. They contain small dissolved molecules
that pass easily from the bloodstream into tissues and cells, allowing for transfer
from the bloodstream into the cells and body tissues. Examples include normal
saline, which is salt in water, and D5W, which is dextrose (sugar) in water. Another
example is lactated Ringer’s, which contains sodium, chloride, potassium, calcium
and lactate. It’s used for aggressive fluid replacement.

14. Contd…

15. Crystalloid Contd…
It is subdivided into :-
 Isotonic
 Hypotonic
 Hypertonic

16. Comparison of Osmotic Effects of Hypertonic, Isotonic, and Hypotonic Fluids
on Red Blood Cells

17. ISOTONIC FLUID
The word Isotonic is come from the Greek and roughly translates to equal or same
tone, The isotonic solution allows the cells to move water and nutrients in & out
of cells. This is necessary for blood cells to perform their function of delivering
oxygen and other nutrients to other part of body.
Isotonic solutions are designed to increase extracellular fluid volume, It contains
similar concentrations of salt & sugar as in the human body. It quickly replace
fluids lost through sweating & supplies a boost of carbohydrates.

18. ISOTONIC FLUID Contd…
Isotonic solutions are IV fluids that have a similar concentration of dissolved
particles as blood. An example of an isotonic IV solution is 0.9% Normal
Saline (0.9% NaCl). Because the concentration of the IV fluid is similar to the
blood, the fluid stays in the intravascular space and osmosis does not cause
fluid movement between compartments. Isotonic solutions are used for
patients with fluid volume deficit (also called hypovolemia) to raise their
blood pressure. However, infusion of too much isotonic fluid can cause
excessive fluid volume (also referred to as hypervolemia).

19. How to identify a solution is isotonic?
When the concentration of the particles (solutes) is similar to that of
plasma, So it doesn’t move into cells and remains within the
extracellular compartment thus increasing intravascular volume.
Types Of Isotonic Solution Include :
• 0.9% Sodium chloride (0.9% NaCl)
• Ringer lactate solution
• 5% Dextrose in water (D5W)

20.  0.9% Sodium chloride (0.9% NaCl)
• Simply salt water contains only water, sodium and chloride.
• Its called normal saline solution because the percentage of
sodium chloride in the solution is similar to the concentration of
sodium and chloride in the intravascular space.

21. 0.9% Sodium chloride (0.9% NaCl) Contd…
When to be given ?
• To treat low extracellular fluid, as an fluid volume deficit from
 Haemorrhage
 Severe vomiting or diarrhoea
 Heavy drainage from GI Suction
• Shock
• Mild Hyponatremia
• Metabolic acidosis (such as diabetic ketoacidosis)

22.  Ringer’s Lactate Solution
• Ringer’s lactate solution is the most physiologically adaptable Fluid
because its electrolyte content is most closely related to the composition
of the body’s blood serum and plasma.
• Another choice for first-line fluid resuscitation for certain patients, such
as those with burn injuries with low blood volume or low blood
pressure.
• It also used as an alkalizing agent, which increases the Ph level of the
body.

23. Ringer’s Lactate Solution Contd…
When to be used ?
To replace GI tract fluid losses (Diarrhea or vomiting)
Drainage
Fluid losses due to burns and trauma
Patients experiencing acute blood loss or hypovolemia

24.  Dextrose 5%
• 5% Dextrose Injection is sterile, it is a parenteral solution containing
dextrose in water for injection intended for IV administration.
• Dextrose is a type of sugar that usually comes from corn or wheat, which
sugar is found in bloodstream.
• It is considered an Isotonic solution, but when the dextrose is metabolised,
the solution actually becomes hypotonic and causes fluid to shift into cells.

25. Dextrose 5% Contd…
How does it work?
 D5W Provides free water that pass through membrane pores to both
intracellular and extracellular spaces . Its smaller size allows the
molecules to pass more freely between compartments simultaneously.
 It provides 170 calories/litre, but it doesn’t replace electrolytes.
 The supplied calories doesn’t enough nutrition for prolonged use. But
still can be added to provide some calories while the patient is Nil per
mouth

26. HYPOTONIC FLUIDS
• Compared with intracellular Fluid ( as well as compared with isotonic
solutions), hypotonic solutions have a lower concentration of solutes
(electrolytes i.e. salt) .
• These Solutions will hydrate cells, although their use may deplete fluid
within the circulatory system, such solution has a decreased solute
concentration and a total movement of water in the cell.
• Hypotonic has a lower concentration of fluid, sugars and salt than
blood

27. Hypotonic Fluids Contd…
Types of Hypotonic Fluids
 0.45% sodium chloride (0.45% NaCl) , 0.33% sodium chloride, 0.2% sodium
chloride, and 2.5% dextrose in water
 Hypotonic fluids are used to treat patients with conditions causing intracellular
dehydration, when fluid needs to be shifted into the cell, such as : -
1) Hypernatremia
2) Diabetic ketoacidosis
3) Hyperosmolar hyperglycemic state

28. HYPERTONIC SOLUTIONS
What is hypertonic solutions?
• Solution that have a higher tonicity or solute concentration. It has a
more concentrated than body fluids. It causes movement of H2O From
cells into the extracellular fluid, hypertonic solutions are used for
soaking wounds. (like 0.9% < 3%)
• Any solution of sodium chloride (NaCl) in water with a concentration
of NaCl higher than that found in physiological saline (0.9%)

29. Hypertonic Solutions Contd…
Examples of Hypertonic Solutions
1. 3% Sodium Chloride (3% NaCl)
• May be prescribed for patients in critical situations of severe
hyponatremia.
• Patients with cerebral Edema may benefit from an infusion of hypertonic
sodium chloride.
2. 5% Dextrose with normal saline (D5 NS)
• Which replaces sodium, chloride and some calories

30. Colloids:
Solutions that contain large molecules that don’t pass the cell membranes,
These are large molecules that can’t easily pass through cell membranes
and are more likely to stay in the blood vessels. When infused, they remain
in the intravascular compartment. examples include albumin,
starch(Hydroxyethyl), gelatin solution.

31. Colloid Solutions Contd…
How does it work?
 It expand the intravascular volume by drawing fluid from the interstitial spaces
into the intravascular compartment through their higher oncotic pressure.
 The same effect as hypertonic crystalloids solutions but it requires
administration of less total volume and have a longer duration of action
because the molecules remain within the intravascular space longer.
Examples of colloid solutions are : -
 5% Albumin (Human albumin solution)
 Hydroxyethalstarches

32. Colloid Solutions Contd…
1. 5% Albumin (Human albumin solution)
• The most commonly utilized colloid solutions.
• It contain plasma proteins fraction obtained from human plasma and
works to rapidly expand the plasma volume used for achievement of
hemodynamic stability in shock states
• It considered a blood transfusion product and requires all the same
nursing precautions used when administering other blood products.
• It can be expensive and its availability is limited to the supply of human
donors

33. Colloid Solutions Contd…
Albumin Contraindications:
a) Severe anemia
b) Heart failure
c) Known sensitivity to albumin
d) ACE Inhibitors drug( Enalapril, Lisinopril, Captopril) should be withheld
for at least 24 hours before administering albumin because of the risk of
atypical reactions, such as Flushing and hypotension

34. THANK
YOU FOR YOUR
ATTENTION