Core pharmacology

Class Group

Crystalloid

Legacy Cicm Level

Level 1

Introduction

intravenous fluid with 9g NaCl in litre of sterile water.
Isotonic crystalloid solution

Indications Uses

1. Initial replacement fluid, in volume depleted or dehydrated patients. Volume depletion may be due to loss of blood, plasma or fluid and electrolytes.
2. Maintenance of hydration during prolonged patient contact time.
3. To keep vein open, as IV route for drugs.

Presentation

500 or 1000mls of 0.9% Sodium Chloride solution in a collapsible plastic flask or bag.

Mechanism of action

1. Plasma volume expander
2. Also expands interstitial fluid volume
3. Plasma volume effect is only temporary as most of the saline moves out of the blood vessels quite quickly

Adverse Effects Toxicity

1. Fluid overload
2. hyperchloremic metabolic acidosis
3. increased risk of renal failure compared to balanced solutions
4. Injury to endothelial glycocalyx

Absorption

IV. BA 100%

Distribution

~15mins:
ISF 750mls
Plasma volume 250mls.
Not distributed to ICF

Metabolism

Unmetabolized

Excretion

Excreted by kidney
Slower than balanced solutions

Special Points

pH 5.0
Osm 308
Tonicity 286

Na 154
Cl 154