Drug therapy reviews: intravenous fluid therapy

The indications for use of large-volume parenteral solutions are reviewed, and the types of fluids administered and their potential hazards are described. The indications discussed are replacement therapy, maintenance therapy and emergency venous access. Hazards presented include thrombophlebitis, infection, volume overload, air embolism, particulate matter and chemical contamination. The indications for specific parenteral fluids, such as saline solutions, dextrose solution, fructose and alkaline solutions are discussed. Also reviewed are agents used to treat alkalosis, intravenous potassium therapy, calcium salts, magnesium salts and mixed solutions. Most clinical situations can be managed with judicious use of 0.9% saline and 5% dextrose with the addition of other electrolytes as determined by the needs of the individual patient.