Guide To IV Fluids - How To Choose The Best One
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- Опубліковано 8 лип 2024
- Guide to choosing the right fluid for your patients. Don't forget, sodium bicarbonate may also be a good choice if you have a patient with severe acidemia and AKI per the BICAR-ICU trial - I just don't use it frequently enough so I didn't put it in the video, and you have to be careful that you don't use it in patients who are having difficulties clearing CO2 due to Le Chatelier's principle increasing production of CO2 in the airways from bicarb. I also did not discuss crystalloid vs colloid here (albumin, blood, etc.) but suffice it to say that in most cases you should be going to crystalloid since there hasn't been strong evidence that colloid helps except in certain conditions (hepatorenal syndrome, large volume paracentesis, SBP, etc.)
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super helpful, this is the best summary of fluids I've come across! one pearl I learned recently is D51/2NS is apparently the most ideal choice for rehydration in sickle cell criss
Thank you...thank you. This is one of the best summary of IV fluids. Thank you
Another consideration is fluid compatibility. Some medications may not be compatible with the fluid you choose, especially when it comes to antibiotics, some of which need to be infused over hours, and therefore too slowly to be used as a maintenance rate. Pharmacy may not catch this as they may not know what is infusing through which IV line.
New PGY2, loving your videos to refresh/organize my thoughts when teaching the interns!
Including relevant trials is very helpful, thanks!
Thank you so much 🙏🙏🙏
Amazing video, do you think hospitals jobs will be saturated in 7 to 10 years?
Hey dr Conan !!! I loved your video a lot. I was wondering what are the actual risk in using LR in acute liver failure. Do patient get Lactic build up ?? there were some RCT's that did not show significant risk with using LR in those patient but I still hear that it is generally avoided. What is your opinion as a clinician ?
While yes, impaired liver function can reduce clearance of lactic acid - I would 100% favor LR over NS in these patients. The lactate content is really quite miniscule, and I'd be more worried about inducing hyperchloremic metabolic acidosis with NS than with LR. Of course, either way you'd need to be pretty cautious with fluid use in a patient with acute liver failure since it will be quite easy to overload them if you aren't careful.
I order fluids by "dose" (bag), so I can count forward in liters my "end time"
Hi. Doctor,
Can 0.9 sodium chloride IV cause chills and increse Heart Rate ? Thx 🙏
No, not that I am aware of
Conan!!
Trackstar!! :)