Intravenous fluids: principles of treatment
Safe and appropriate prescribing of intravenous fluids requires an understanding of fluid and electrolyte homeostasis, the physiological responses to injury and disease, and the properties of IV fluids.
Problems arising from inappropriate fluid therapy can increase morbidity and prolong hospital stays.
Intravenous fluid therapy is required when enteral intake is insufficient, to replace large fluid losses or when very rapid replacement is necessary. An accurate record of overall intake and output is required for appropriate IV fluid prescription.
IV solutions can be crystalloid (containing small molecules such as sodium chloride or glucose) or colloid (dispersions of large organic molecules). Solutions with electrolyte compositions more closely matched with plasma are often called “balanced solutions” (eg, Hartmann’s solution). Successful therapy may be indicated by improvement in a patient’s clinical signs (eg, weight, urine output, capillary refill time), biochemistry and comfort. Serious complications can result from over-administration of fluids.
This article was first published in Hospital Pharmacist (2008;15:271) and has been revised by Katharina Floss, who is directorate pharmacist for critical care, theatres and anaesthetics at Oxford Radcliffe Hospitals NHS Trust. Mark Borthwick is consultant pharmacist for critical care at John Radcliffe Hospital and Christine Clark is a pharmacist and freelance journalist.
Citation: Clinical Pharmacist URI: 11085082
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