This article provides an overview of how fluid is normally distributed in the body, what types of fluids can be given to correct any fluid imbalances, and how to calculate the volume of fluid needed for each dehydrated patient.Īn adult animal's body weight is composed of about 60% water, which is distributed throughout the intracellular and extracellular compartments. But before the fluids can be administered, the veterinarian must decide what fluids to provide and at what rate. Thus, 40 to 60 meq of potassium per liter in one-half isotonic saline is preferred.” Mount et al.Hey there! We've got an updated version of this article available here.Īs discussed in " Fluid therapy in small animals: The technician's role," technicians are a vital part of making sure intravenous (IV) fluids are administered correctly in dehydrated patients. “Although isotonic saline is often the initial replacement fluid used in treating diabetic ketoacidosis or nonketotic hyperglycemia, the addition of potassium will make this a hypertonic fluid (since potassium is as osmotically active as sodium), thereby delaying reversal of the hyperosmolality. Thus, concurrent potassium replacement may be another indication for the use of one-half isotonic saline.” Kitabchi et al. “Potassium repletion affects the saline solution that is given, since potassium is as osmotically active as sodium. The timing of one-half isotonic saline therapy may also be influenced by potassium balance. When a patient is NPO and is on fluids, putting 20 KCL in it will give them about 40-50 per day. However, it is thought that 1600 to 2000 mg ( 40 to 50 milliequivalents ) per day for adults is adequate.” Mayo Clinic. “Because lack of potassium is rare, there is no RDA or RNI for this mineral. If you are planning to give more than 3-4 liters of normal saline, switch to LR because of the risk of “expansion acidosis”. For Volume Replacementįree water (orally, via NGT, via PEG tube)Įven 1/4 NS or D5 1/4 NS works for maintenance fluids The reason for giving dextrose (D5) is to prevent catabolism. Pre-procedure or NPO patient who is euvolemic: treat this patient like a surgical patient if the patient is going to be NPO for longer than 6-12 hours. NB: For the hypervolemic patient, avoid fluids at all cost.Īlso, patients who are healthy, can take po, and are admitted for an elective reason don’t need fluids. The patient who needs free water, e.g.The euvolemic patient who can take PO and has been admitted for an elective reason (e.g.The euvolemic patient who will be NPO (or take inadequate po).patient with sepsis, pneumonia, intractable nausea/vomiting, etc). When it comes to IV fluids, there are a few basic scenarios. “Also, remember that dextrose gets almost immediately metabolized to water and CO2 when it enters the circulation so it is not osmotically active for too long.” Such patients need isotonic fluids (normal saline or Lactated Ringers). As such, D5 1⁄2 NS is NOT appropriate for most medical patients who are hypovolemic. That’s why D5 1⁄2 NS is not an isotonic solution. Notice that sodium plays a bigger part in determining your osmolality than glucose. Serum osmolality = 2 (Na+) + Glucose/18 + BUN/2.8 Should you use NS, LR, or 1/2 NS as Maintenance fluids?
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