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Basic rules of parenteral fluid therapy.

M S Oh1, H-J Kim

  • 1Department of Medicine, State University of New York, Health Science Center at Brooklyn, Brooklyn, N.Y. 11203, USA. moh@netmail.hsbklyn.edu

Nephron
|October 29, 2002
PubMed
Summary
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Parenteral fluid therapy requires careful consideration of fluid balance, electrolyte content, and administration goals. Understanding these basic rules helps reduce confusion for physicians ordering intravenous fluids.

Area of Science:

  • Medicine
  • Physiology
  • Pharmacology

Background:

  • Physicians often experience confusion and concern regarding intravenous (IV) fluid orders.
  • Parenteral fluid therapy involves complex considerations of water, electrolytes, and nutrient balance.

Purpose of the Study:

  • To formulate basic rules for parenteral fluid therapy.
  • To alleviate confusion and concern associated with IV fluid orders among physicians.

Main Methods:

  • Review and synthesis of fundamental principles of fluid and electrolyte balance.
  • Consideration of physiological factors influencing water and electrolyte output (kidney, skin, lung).
  • Analysis of IV fluid composition, including electrolytes, nutrients, and osmolality.

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Main Results:

  • Key rules emphasize avoiding excessive fluid administration.
  • Understanding water and electrolyte output, intake, and distribution volume (extracellular fluid - ECF) is crucial.
  • Awareness of IV solution properties, such as water content in hypertonic saline, is important.

Conclusions:

  • Adherence to basic principles can simplify and improve parenteral fluid therapy.
  • Physicians should be familiar with various IV solutions and additives.
  • Consideration of oncotic pressure-pulmonary artery wedge pressure (COP-wedge) gradient aids in fluid type selection.