هل يمكنني استخدام الدكستروز مونو هيدرات في وصفة آيس كريم مع إضافة السكر الأبيض والماء وبودرة اللبن بنسبة دهون 28% كم أضيف دكستروز إذ ممكن اسمحولي أن كنت خارج الموضوع
Really great explanation! :D I understand how these IV fluids interact with the RBC, but what about the movement of fluid inside the vessel vs. the interstitial volume? With D5W can we expect fluids to move from the intravascular space into the interstitial volume once metabolized?
Keisha-thanks for the question!! Water and glucose move freely between the vasculature and the interstitial space. Thus, the effect seen in the video would be seen in the interstitial space as well, causing an increase in interstitial volume 👍
I don’t get it. Somebody please help. I understand that , 0.9 grams of salt /100 ml is isotonic like the blood. But 5 grams of glucose in spite of the blood having 100 mg of glucose/ 100 ml still isotonic???
Hi there! Glucose is considered a penetrating solute. It can cross the cell membrane by diffusion (using glucose transporters). Any particle that can freely enter/exit the cell has zero effect on tonicity!
Which one is better and what are conditions where we have to use them? Also if cells burst in dextrose fluid condition then what are it's negative effects. What will happen if we give these to normal person? Please sir clear my doubt
HI Anoop! Great questions! I wouldn't say that one I.V. solution is better than the other. It all depends on what the clinician is trying to accomplish. For example, the benefits of 0.9% NaCl is that it will replenish fluid loss in the ECF (since Na+/Cl- will remain in the ECF, the fluid will as well) and will replace lost Na+/Cl-. However, 5% dextrose is a way to administer fluid as well while also providing a glucose source. Dextrose, for example, might be offered to someone with low blood sugar. So, IVs are chosen and administered based on patient needs. Note: there are many IV solutions and administration of an IV is a complicated process that requires careful monitoring. But just from a physio point of view, no IV is necessarily better or worse.
Here are some great resources you might find interesting: Uses of saline: www.ncbi.nlm.nih.gov/books/NBK545210/#:~:text=The%20following%20are%20primary%20indications,Mild%20sodium%20depletion Effects of hypotonic solutions (notice the cerebral edema, or swelling of brain tissue): www.ncbi.nlm.nih.gov/pmc/articles/PMC3567905/
Hello! I dont understand why in the last photo, the osmolarity of plasma is zero after all the glucose enters the cell? Shouldn't it be 0.3 like in the beginning? So, we will have isoosmotic fluids outside and inside the cell. Furthermore, if all the glucose in the cell is metabolized, it means that there is no glucose too, so the osmolarity outside and inside the cell should be the same again. What I am missing? :D
Hi Milica! Thanks for the question! See below: In the example from the video, I simplified it by putting the cells into a solution of 5% dextrose in H2O. This was meant to highlight the effect that 5% dextrose has on the cells. So, in the example from the video, dextrose is the only particle in the ECF (there isn't Na+, K+, Cl-, etc. This isn't actually what the ECF looks like :) but it helps simplify the problem and doesn't change the final result). So here's why the ECF ended hyposmotic, with an osmolarity of 0: 5% dextrose in H2O has an initial osmolarity of 0.3, so the "plasma" has an initial osmolarity of 0.3. However, since dextrose can enter the cells using the transporter, eventually getting metabolized, we will end up with no glucose in the ECF over time. This is why the osmolarity in the ECF is said to eventually go down to 0: since all the dextrose entered (and we are pretending that dextrose was the only solute in the ECF to start with), then there will be no solutes in the ECF after dextrose enters the cells. Essentially, we are left with pure water in the ECF (osmolarity of 0) and this is why water will enter the cells. So, the osmolarities started off isosmotic, but the ECF solute concentration decreased, leading to the ECF being hyposmotic to the plasma. **Note: even if you added 5% dextrose in H2O to a realistic isosmotic plasma (with Na+, ions, and protein, etc.) the results would be the same. The ECF would become hyposmotic to the cells due to dextrose diffusing into the cells.
Halo, Hala Kitty! :D Here are some examples: 1.) Nonpolar molecules (steroid hormones like aldosterone, testosterone). These are huge molecules but since they are non polar they can cross the nonpolar, hydrophobic cell bilayer. 2.) Polar molecules that are quite small (urea and ammonia are good examples). Polar molecules usually are rejected by the nonpolar bilayer. However, if small enough they can cross the cell membrane. If you want to review the cell membrane and why it allows certain things to cross but not others, here's a video below: ua-cam.com/video/t3JlQptIR8Q/v-deo.html
hi, just wondering about the dextrose solution, does the water in the infusion move between compartments? and does any fluid compartment get larger as a result of this infusion? if so which one? would really appreciate it if you could clear my doubts, thank you!
Hey, C. Charlie! Yup! The 5% dextrose solution is essentially composed of water plus the solute (dextrose/glucose). In the hypotonic 5% dextrose solution, water from the ECF is moving by osmosis into the ICF, driven towards the higher osmolarity in the ICF. Adding the solution to the plasma/ECF will increase the volume of the ECF compartment. 5% dextrose is used in some cases to add volume to the ECF compartment and restore fluid volume.
Hi Leah! One thing to keep in mind. Isosmotic is different than isotonic. The dextrose solution is isosmotic to our internal environment (not isotonic) in the bag. It has the same osmolarity as our internal environment and thus is isosmotic. However, when we add this solution to our ECF or inside our body, since the glucose can cross the cell membrane the solution will not be isosmotic anymore. The glucose will diffuse into our cells. Since water always follows the higher concentration of solute, it will enter our cells. This is why 5% dextrose in water is considered hypotonic. So to recap: 1.) 5% dextrose starts off isosmotic (with same osmolarity) 2.) When added to the body, glucose enters cell, making solution hyposmotic compared to the cells. 3.) Water will enter the cells 4.) Whenever water enters the cells, the solution was hypotonic. If it still doesn't make complete sense, the videos below could be really helpful! ua-cam.com/video/iztSDwuHDHw/v-deo.html ua-cam.com/video/_yNsY1MBPWg/v-deo.html
@@physioflip it would still be hypotonic however it would take a longer time to metabolise all the glucose and thus water will diffuse into the cell slower and later
Hi Hunyn! Thanks for the question! As a physio professor, I love answering questions :D Osmolarity of 5% dextrose in normal saline is ~0.6. As mentioned in the video above 0.9% NaCl has an osmolarity of 0.3, while 5% dextrose does too (these are not quite 0.3 in reality, but they are considered isosmotic to normal plasma so we'll just say they are about 0.3). Similarly, you can calculate the osmolarity of any IV solution. For example, see if you can practice calculating the osmolarity of 10% dextrose in normal saline, or 3.3% dextrose in normal saline. Feel free to reply with your answers below and I'll get back to you to confirm if they're right! Happy phyiso-ing! :D
Happy to help! To clarify: which solution are you saying has an osmolarity of 360 mOsM/L? 360 mOsM/L would be an osmolarity of 0.360. If you mean this is the osmolarity for 5% dextrose in 0.9% NaCl (which is normal saline) that would not be correct. The osmolarity of this solution is nearly double that (close to 0.6). Not sure what source on google mentioned that but it’s not accurate. (Google can sometimes do that :/) Here’s a nice trust worthy resource (US Food and Drug Administration) which also shows that the osmolarity of 5% dextrose in normal saline is around 0.6 (they report osmolarity of 560 mOsM/L which is osmolarity of .56). check out the table on page 2: www.accessdata.fda.gov/drugsatfda_docs/label/2004/19631s023lbl.pdf But maybe you meant a different solution? Once we clarify that to make sure we are on the same page it’d be easier to help with the calculation!
![Дон ДОН, Алаудинов и СБЕЖАВШИЕ из под Курска ахматовцы 😁 [Пародия]](http://i.ytimg.com/vi/dEfCf5IK26Q/mqdefault.jpg)
Great explanation I have ever seen on this topic!!,,,Keep u..
Thanks
هل يمكنني استخدام الدكستروز مونو هيدرات في وصفة آيس كريم مع إضافة السكر الأبيض والماء وبودرة اللبن بنسبة دهون 28%
كم أضيف دكستروز إذ ممكن
اسمحولي أن كنت خارج الموضوع
Great explanation! Tysm!
YWSM! :D
Really great explanation! :D
I understand how these IV fluids interact with the RBC, but what about the movement of fluid inside the vessel vs. the interstitial volume? With D5W can we expect fluids to move from the intravascular space into the interstitial volume once metabolized?
Keisha-thanks for the question!! Water and glucose move freely between the vasculature and the interstitial space. Thus, the effect seen in the video would be seen in the interstitial space as well, causing an increase in interstitial volume 👍
@@physioflip Thank you for your response! That makes sense :D
thank you / osmolarity of intracellular fluid is the reference
Totally. That 0.3 Osmolarity number is key :)
I don’t get it. Somebody please help. I understand that , 0.9 grams of salt /100 ml is isotonic like the blood. But 5 grams of glucose in spite of the blood having 100 mg of glucose/ 100 ml still isotonic???
Hi there! Glucose is considered a penetrating solute. It can cross the cell membrane by diffusion (using glucose transporters). Any particle that can freely enter/exit the cell has zero effect on tonicity!
So even if you inject an incredibly sugary glucose solution, if it’s only glucose in water, then the solution will be hypotonic.
All love 💜
Which one is better and what are conditions where we have to use them? Also if cells burst in dextrose fluid condition then what are it's negative effects.
What will happen if we give these to normal person?
Please sir clear my doubt
HI Anoop! Great questions! I wouldn't say that one I.V. solution is better than the other. It all depends on what the clinician is trying to accomplish. For example, the benefits of 0.9% NaCl is that it will replenish fluid loss in the ECF (since Na+/Cl- will remain in the ECF, the fluid will as well) and will replace lost Na+/Cl-. However, 5% dextrose is a way to administer fluid as well while also providing a glucose source. Dextrose, for example, might be offered to someone with low blood sugar. So, IVs are chosen and administered based on patient needs. Note: there are many IV solutions and administration of an IV is a complicated process that requires careful monitoring. But just from a physio point of view, no IV is necessarily better or worse.
Here are some great resources you might find interesting:
Uses of saline: www.ncbi.nlm.nih.gov/books/NBK545210/#:~:text=The%20following%20are%20primary%20indications,Mild%20sodium%20depletion
Effects of hypotonic solutions (notice the cerebral edema, or swelling of brain tissue): www.ncbi.nlm.nih.gov/pmc/articles/PMC3567905/
Hello! I dont understand why in the last photo, the osmolarity of plasma is zero after all the glucose enters the cell? Shouldn't it be 0.3 like in the beginning? So, we will have isoosmotic fluids outside and inside the cell. Furthermore, if all the glucose in the cell is metabolized, it means that there is no glucose too, so the osmolarity outside and inside the cell should be the same again. What I am missing? :D
Hi Milica! Thanks for the question! See below:
In the example from the video, I simplified it by putting the cells into a solution of 5% dextrose in H2O. This was meant to highlight the effect that 5% dextrose has on the cells. So, in the example from the video, dextrose is the only particle in the ECF (there isn't Na+, K+, Cl-, etc. This isn't actually what the ECF looks like :) but it helps simplify the problem and doesn't change the final result). So here's why the ECF ended hyposmotic, with an osmolarity of 0:
5% dextrose in H2O has an initial osmolarity of 0.3, so the "plasma" has an initial osmolarity of 0.3. However, since dextrose can enter the cells using the transporter, eventually getting metabolized, we will end up with no glucose in the ECF over time. This is why the osmolarity in the ECF is said to eventually go down to 0: since all the dextrose entered (and we are pretending that dextrose was the only solute in the ECF to start with), then there will be no solutes in the ECF after dextrose enters the cells. Essentially, we are left with pure water in the ECF (osmolarity of 0) and this is why water will enter the cells.
So, the osmolarities started off isosmotic, but the ECF solute concentration decreased, leading to the ECF being hyposmotic to the plasma.
**Note: even if you added 5% dextrose in H2O to a realistic isosmotic plasma (with Na+, ions, and protein, etc.) the results would be the same. The ECF would become hyposmotic to the cells due to dextrose diffusing into the cells.
@@physioflip Thank you!
@@milicamilic7784 You got it!
tysm!!
Thank you so much, what other substances than glucose that can diffuse into the cell?
Halo, Hala Kitty! :D Here are some examples:
1.) Nonpolar molecules (steroid hormones like aldosterone, testosterone). These are huge molecules but since they are non polar they can cross the nonpolar, hydrophobic cell bilayer.
2.) Polar molecules that are quite small (urea and ammonia are good examples). Polar molecules usually are rejected by the nonpolar bilayer. However, if small enough they can cross the cell membrane.
If you want to review the cell membrane and why it allows certain things to cross but not others, here's a video below:
ua-cam.com/video/t3JlQptIR8Q/v-deo.html
Physio Flip
Thank you so much sir ✨👌🏼
amazingggg
hi, just wondering about the dextrose solution, does the water in the infusion move between compartments? and does any fluid compartment get larger as a result of this infusion? if so which one? would really appreciate it if you could clear my doubts, thank you!
Hey, C. Charlie!
Yup! The 5% dextrose solution is essentially composed of water plus the solute (dextrose/glucose). In the hypotonic 5% dextrose solution, water from the ECF is moving by osmosis into the ICF, driven towards the higher osmolarity in the ICF.
Adding the solution to the plasma/ECF will increase the volume of the ECF compartment. 5% dextrose is used in some cases to add volume to the ECF compartment and restore fluid volume.
@@physioflip could you explain how it would expand ecf please
hi im confused why dextrose is isotonic in the bag but hypotonic in the cell, can you please explain, thanx
Hi Leah! One thing to keep in mind. Isosmotic is different than isotonic.
The dextrose solution is isosmotic to our internal environment (not isotonic) in the bag. It has the same osmolarity as our internal environment and thus is isosmotic.
However, when we add this solution to our ECF or inside our body, since the glucose can cross the cell membrane the solution will not be isosmotic anymore. The glucose will diffuse into our cells.
Since water always follows the higher concentration of solute, it will enter our cells. This is why 5% dextrose in water is considered hypotonic. So to recap:
1.) 5% dextrose starts off isosmotic (with same osmolarity)
2.) When added to the body, glucose enters cell, making solution hyposmotic compared to the cells.
3.) Water will enter the cells
4.) Whenever water enters the cells, the solution was hypotonic.
If it still doesn't make complete sense, the videos below could be really helpful!
ua-cam.com/video/iztSDwuHDHw/v-deo.html
ua-cam.com/video/_yNsY1MBPWg/v-deo.html
Physio Flip thank you !
@@SaraRuss-gb8sg You're so welcome! Let me know if you have any other questions!
what about the tonicity of dextrose 25% ??
Hi Aliaa! Based on the video, what do you (or others seeing this comment :) think the tonicity might be for 25% dextrose?
@@physioflip it would still be hypotonic however it would take a longer time to metabolise all the glucose and thus water will diffuse into the cell slower and later
how to calculate osmolarity of 5% dextrose in normal saline
Hi Hunyn! Thanks for the question! As a physio professor, I love answering questions :D
Osmolarity of 5% dextrose in normal saline is ~0.6. As mentioned in the video above 0.9% NaCl has an osmolarity of 0.3, while 5% dextrose does too (these are not quite 0.3 in reality, but they are considered isosmotic to normal plasma so we'll just say they are about 0.3). Similarly, you can calculate the osmolarity of any IV solution. For example, see if you can practice calculating the osmolarity of 10% dextrose in normal saline, or 3.3% dextrose in normal saline. Feel free to reply with your answers below and I'll get back to you to confirm if they're right!
Happy phyiso-ing! :D
@@physioflip thank you for your reply but I checked on Google it was 360 mosm/l .. I just want to know how the calculation haopens
Happy to help! To clarify: which solution are you saying has an osmolarity of 360 mOsM/L?
360 mOsM/L would be an osmolarity of 0.360. If you mean this is the osmolarity for 5% dextrose in 0.9% NaCl (which is normal saline) that would not be correct. The osmolarity of this solution is nearly double that (close to 0.6). Not sure what source on google mentioned that but it’s not accurate. (Google can sometimes do that :/)
Here’s a nice trust worthy resource (US Food and Drug Administration) which also shows that the osmolarity of 5% dextrose in normal saline is around 0.6 (they report osmolarity of 560 mOsM/L which is osmolarity of .56). check out the table on page 2: www.accessdata.fda.gov/drugsatfda_docs/label/2004/19631s023lbl.pdf
But maybe you meant a different solution? Once we clarify that to make sure we are on the same page it’d be easier to help with the calculation!
@@physioflip thank you very much sir.. it was of great help
@@physioflip sir u are the Best