Isotonic fluids... what to use where ??!!

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Normal Saline (0.9% NaCl)

  • High chloride → can cause hyperchloremic metabolic acidosis
  • Acidic pH (~5.5) – not ideal for large volume resuscitation
  • No potassium or calcium – safe in hyperkalemia & blood transfusions

Ringer’s Lactate (RL)

  • Closer to plasma composition
  • Contains lactate → converted to bicarbonate in the liver (good for acidosis)
  • Contains K⁺ and Ca²⁺ – avoid in hyperkalemia and with blood transfusions

D5W

  • 5g dextrose/100ml
  • Turns hypotonic after glucose metabolism

:rosette:Which one to use where?? :rosette:

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Normal Saline is great for routine needs, but large volumes can cause acid issues. Ringer’s Lactate is better for major fluid loss like trauma, as it’s more balanced. D5W provides free water for dehydration or drug delivery, not for volume replacement.
Each has its specific role.

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Re-hydration
Trauma
Acid base balance
Fluid loss
Drug administration

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