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Fluids, Electrolytes, Gatorade, and Sweat


1

What is hypertonic saline?

Normal saline is 0.9% sodium chloride. Hypertonic saline is 7.5% sodium chloride (eight times as concentrated as normal saline).

Key Points: Ion Concentrations in Crystalloid Solutions

  • 1.

    One-half normal saline or 0.45% NaCl: 77 mEq of Na+, 77 mEq of Cl-

  • 2.

    Normal saline or 0.9% NaCl: 154 mEq of Na+, 154 mEq of Cl-

  • 3.

    Hypertonic normal saline or 7.5% NaCl: 1283 mEq of Na+, 1283 mEq of Cl-

  • 4.

    Lactated Ringer’s: 130 mEq of Na+, 110 mEq of Cl-, 38 mEq of lactate, 4 mEq of K+, and 3 mEq of Ca+

2

What is hypertonic saline good for?

Resuscitation. The initial hypothesis was that a little hypertonic saline would pull extravascular water into the intravascular compartment, rapidly restoring volume. It now appears that an osmotic jolt (even a transient jump from 140 to 180 mOsm) would pacify circulating neutrophils so that they do not stick to the endovasculature and provoke posttraumatic inflammation.

3

Is hypertonic saline good for anything else?

Pacification of “primed” neutrophils should decrease the risk of posttraumatic multiple organ failure.

4

How do you convert 1 g of sodium into milliequivalents (mEq)?

Divide by the atomic weight of sodium:

  • One gram (1 g/1000 mg) of sodium = 43.5 mEq

5

How many mEq of sodium are in 1 teaspoon of salt?

104 mEq (2400 mg).

6

How many mEq of sodium are in an 8-oz bottle of Gatorade?

5 mEq.

7

How much does a 40-lb block of salt cost?

$3.40 at the feed store.

8

What is the electrolyte content of intravenous fluids?

See Table 8.1 .

Table 8.1
Electrolyte Content of Intravenous Fluids
Solution (mEq/L) Sodium Potassium Chloride Bicarbonate/Lactate
Normal saline (0.9% NaCl) 154 — 154 —
Ringer’s lactate solution 130 4 109 28 a
5% dextrose and 1/2 normal saline 77 — 77 —

a Lactate is converted immediately to bicarbonate.

9

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