fluids

Hyponatremia Correction For Hyperglycemia

Sodium is the primary cation (positive-charged ion) in the extracellular space. Therefore, dilutional hyponatremia can occur if free water is added to the extracellular space from fluid shifts and infusions. Let's look at this basic...

Intravenous Fluid Comparison Table

Intravenous (IV) fluids are ubiquitous in medicine. Crystalloid fluids consist of electrolytes and/or dextrose. They are traditionally used to replace ongoing fluid losses, hydrate patients who cannot tolerate enteral intake, reconstitute medications, etc. Colloids...

Isolyte S

Isolyte® S is a balanced crystalloid solution created by B. Braun Medical Inc. As a cardiothoracic anesthesiologist and intensivist, it's the crystalloid I use the most in the perioperative and ICU settings. Compared to...

Banana Bag

The "banana bag" is a colloquial term referring to isotonic crystalloid fluid premixed with thiamine, folic acid, and a multivitamin (which creates the characteristic yellow coloration). Some clinicians opt for a banana bag when...

Why Does Albumin Create Foam?

If you've ever administered albumin, you've undoubtedly seen the bubbles and foam while infusing this colloid solution. As the volume of albumin decreases in a fixed container (ie, glass bottle), a vacuum effect is...

Overnight Fluid Boluses For A “Low MAP”

2 AM: “Hey doc, the patient’s MAP (mean arterial pressure) has been in the high 50s for the last hour. Urine output isn’t that great either. Wanna bolus some fluid?” This knee-jerk reaction is a...

Stopcock In Blood Warmer Tubing

Over the years, I've used many types of fluid warmers from rapid infusers like the Belmont and Level 1 to more conventional products like the Ranger series. The priming process is somewhat different for...

The Endothelial Glycocalyx

The glycocalyx is a surface layer of proteins lining the luminal (blood-containing) side of vascular endothelium. It plays an important role as a vascular barrier, provides structural support, facilitates cellular interactions, mitigates vasomotor tone,...

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