In children requiring intravenous fluid for hydration maintenance, which out of hypotonic saline and isotonic saline is less likely to result in the development of hyponatraemia?

2017 ◽  
Vol 53 (3) ◽  
pp. 309-313 ◽  
Author(s):  
Michael MA Tran ◽  
Esther M Tantsis ◽  
Joanne M Ging
Keyword(s):  
Isotonic Saline ◽  
Intravenous Fluid ◽  
Hypotonic Saline

scholarly journals Options of severe preeclampsia treatment

2020 ◽  
pp. 278-279
Author(s):  
R.O. Tkachenko
Keyword(s):  
Blood Pressure ◽  
Pulmonary Edema ◽  
Isotonic Saline ◽  
Colloid Osmotic Pressure ◽  
Interstitial Space ◽  
Intravenous Fluid ◽  
Infusion Therapy ◽  
Electrolyte Balance ◽  
Protein Loss ◽  
Fluid Infusion

Background. Preeclampsia (PE) occurs in 2-8 % of all pregnancies. Every day 210 women die from PE, and neonatal losses are even greater (1380 children per day). Fatal complications of severe PE include cerebral hemorrhage, cerebral edema, pulmonary edema, placental abruption, adrenal hemorrhage, dissecting aortic aneurysm, HELLP syndrome, disseminated intravascular coagulation syndrome. Excessive intravenous fluid infusion is one of the causes of pulmonary edema in PE. Objective. To describe the options of severe PE treatment. Materials and methods. Analysis of literature data on this issue. Results and discussion. The pathogenesis of PE is based on total damage to the vascular endothelium, which leads to an increase in its permeability, including for albumin molecules. Plasma protein loss is accompanied by a drop in oncotic blood pressure and fluid leakage into the interstitial space. Thus, in patients with PE there is an associated disturbance of fluid and electrolyte balance: along with intravascular dehydration there is extravascular hyperhydration. Infusion therapy (IT) allows to overcome this imbalance and to increase the colloid-osmotic pressure. According to modern views, a restricted IT regimen improves the effects of PE treatment. There are two ways to correct this disorder: an increase in oncotic blood pressure due to infusion of albumin (indicated in case of blood albumin levels <25 g/L) and the administration of osmotically active drugs, such as Reosorbilact (“Yuria-Pharm”). The latter option prevents the loss of fluid from the vascular bed and promotes its return to the vessels from the intercellular space. The total fluid volume should be limited to physiological needs, taking into account pathological losses (not more than 1 ml/kg/h). The maximum IT volume should not exceed 800 ml per day. The drugs of choice for IT before delivery are balanced isotonic saline solutions and solutions containing 6 % sorbitol. Fresh-frozen plasma is not recommended for the correction of colloid-oncotic pressure. Influence on the redistribution of fluid in the interstitial space without the introduction of significant volumes of infusion solutions is the main principle of low-volume IT. Recommendations for the administration of Reosorbilact comply with this principle. The low osmolarity of Reosorbilact and its ability to improve the osmotic properties of blood justify the use of this drug in women with PE. Conclusions. 1. PE occurs in 2-8 % of all pregnancies. 2. Excessive intravenous fluid infusion is one of the causes of pulmonary edema in PE. 3. Restricted IT mode improves the consequences of PE treatment. 4. Osmotically active drugs (Reosorbilact) are prescribed for this purpose.

Influence of Volume Expansion on Renal Diluting Capacity in the Rat

1974 ◽  
Vol 46 (3) ◽  
pp. 331-345
Author(s):  
M. Martinez-Maldonado ◽  
G. Eknoyan ◽  
W. N. Suki
Keyword(s):  
Volume Expansion ◽  
Collecting Duct ◽  
Isotonic Saline ◽  
Extracellular Fluid ◽  
Free Water ◽  
Fluid Volume ◽  
Extracellular Fluid Volume ◽  
Sodium Reabsorption ◽  
Water Excretion ◽  
Hypotonic Saline

1. The functional capacity of Henle's loop was examined during hypotonic, isotonic and hypertonic extracellular fluid volume expansion. To eliminate a possible role of antidiuretic hormone (ADH) in the alteration of free water excretion, rats with congenital diabetes insipidus were used. The infusion of hypotonic saline resulted in a progressive rise in free water clearance (CH2O) throughout the range of urine flow (V) attained. Similar results were obtained in rats treated chronically with deoxycorticosterone acetate (DOCA). The infusion of isotonic saline (sodium chloride, 154 mmol/l) produced an initial rise in CH2O until V represented 10% of the filtered load, after which CH2O appeared to reach a plateau. The limitation of CH2O was more marked when hypertonic saline was infused. Medullary and papillary non-urea solute (NUS) concentration rose progressively with the increasing concentration of the saline solution infused. 2. The greater fractional sodium excretion (FENa) after acute isotonic and hypertonic volume expansion is probably the result of inhibition of sodium reabsorption in the collecting duct, although inhibition in the ascending limb cannot be entirely excluded. The depression of CH2O as a function of V seen during acute isotonic or hypertonic volume expansion can be attributed in part to enhanced water back-diffusion from the collecting duct consequent to the increasing medullary and papillary interstitial NUS concentration, even in the absence of ADH. 3. Chronic expansion of extracellular fluid volume by DOCA administration did not modify the response to hypotonic saline infusion.

Isotonic versus hypotonic saline solution for maintenance intravenous fluid therapy in children: a systematic review

2015 ◽  
Vol 30 (7) ◽  
pp. 1163-1172 ◽  
Author(s):  
April P. Padua ◽  
Josep Ryan G. Macaraya ◽  
Leonila F. Dans ◽  
Francisco E. Anacleto
Keyword(s):  
Systematic Review ◽  
Fluid Therapy ◽  
Saline Solution ◽  
Intravenous Fluid ◽  
Intravenous Fluid Therapy ◽  
Hypotonic Saline
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