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close this bookThe Clinical Use of Blood - Handbook (WHO; 2002; 222 pages)
View the documentIntroduction
open this folder and view contentsThe appropriate use of blood and blood products
close this folderReplacement fluids
View the documentKey points
View the documentIntravenous replacement therapy
View the documentIntravenous replacement fluids
View the documentMaintenance fluids
View the documentSafety
View the documentOther routes of fluid administration
View the documentCrystalloid solutions
View the documentPlasma-derived (natural) colloid solutions
View the documentSynthetic colloid solutions
open this folder and view contentsBlood products
open this folder and view contentsClinical transfusion procedures
open this folder and view contentsAdverse effects of transfusion
open this folder and view contentsClinical decisions on transfusion
open this folder and view contentsGeneral medicine
open this folder and view contentsObstetrics
open this folder and view contentsPaediatrics & neonatology
open this folder and view contentsSurgery & anaesthesia
open this folder and view contentsAcute surgery & trauma
open this folder and view contentsBurns
View the documentGlossary
View the documentBack cover
 

Crystalloid solutions

NORMAL SALINE (Sodium chloride 0.9%)

Infection risk

Nil

Indications

Replacement of blood volume and other extracellular fluid losses

Precautions

• Caution in situations where local oedema may aggravate pathology: e.g. head injury
• May precipitate volume overload and heart failure

Contraindications

Do not use in patients with established renal failure

Side-effects

Tissue oedema can develop when large volumes are used

Dosage

At least 3 times the blood volume lost

BALANCED SALT SOLUTIONS

Examples

• Ringer’s lactate
• Hartmann’s solution

Infection risk

Nil

Indications

Replacement of blood volume and other extracellular fluid losses

Precautions

• Caution in situations where local oedema may aggravate pathology: e.g. head injury
• May precipitate volume overload and heart failure

Contraindications

Do not use in patients with established renal failure

Side-effects

Tissue oedema can develop when large volumes are used

Dosage

At least 3 times the blood volume lost

DEXTROSE and ELECTROLYTE SOLUTIONS

Examples

• 4.3% dextrose in sodium chloride 0.18%
• 2.5% dextrose in sodium chloride 0.45%
• 2.5% dextrose in half-strength Darrow’s solution

Indications

Generally used for maintenance fluids, but those containing higher concentrations of sodium can, if necessary, be used as replacement fluids

Note

2.5% dextrose in half-strength Darrow’s solution is commonly used to correct dehydration and electrolyte disturbances in children with gastroenteritis

Several products are manufactured for this use. Not all are suitable. Ensure that the preparation you use contains:

• Dextrose

2.5%

• Sodium

60 mmol/L

• Potassium

17 mmol/L

• Chloride

52 mmol/L

• Lactate

25 mmol/L

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