Fluids, electrolytes and nutrition

Question 1

When would you want to avoid giving D5 for fluid resuscitation?

Answer 1

Hyperglycemia, neuronal injury due to increase ICP as glucose crosses BBB

Question 2

When should colloids (aka albumin) be considered?

Answer 2

• If you need a shift of extracellular fluid (aka ascites)
• Trial of large volume of crystalloids (4-6 L)
  and Albumin < 2.5 g/dL

Question 3

What is an appropriate hypertonic saline titration to hyponatremia?

Answer 3

0.5 - 2 mEq/Lhr to achieve 120-125 mmol/L to avoid adverse neurologic outcomes