why is 0.9% sodium chloride used as a fluid replacement in the human body?

[JPINFV]

Looking through my class notes a second time, it discusses D5W for IV for euvolemic hypernatremia and 0.45 saline for hypovolemic hypernatremia. I could have sworn, though, that I've heard sterile water being administered for hypernatremia, however it's definitely not something to be done without lab values.

[DFIB]

Fluid replacement following severe dehydration when you don't want to increase the total body salt load. Hypernatremia is more often due to low fluid levels than excess sodium.

I am not busting your chops but have you ever actually seen sterile water infused IV with positive results?

I would be really afraid it cause horrible things to my patient.

I was typing at the same time as you so you can disregard this comment and question.

Edited October 16, 2011 by DFIB

[Kaisu]

I could have sworn, though, that I've heard sterile water being administered for hypernatremia, however it's definitely not something to be done without lab values.

The safety alerts regarding this also recommend education and intense training early in medical school to teach doctors to NEVER do this.

[mobey]

I have heard of D5W being infused in dehydration with hypernatremia under the theory that the body will use up/store the dextrose, leaving free water.

[Kaisu]

I have heard of D5W being infused in dehydration with hypernatremia under the theory that the body will use up/store the dextrose, leaving free water.

Absolutely correct. In this particular patient death, the patient was diabetic with extremely high BGL. The doc decided against the D5W for this reason. The correct thing to do would have been to use the D5W and correct the BGL with insulin.

[Kiwiology]

Look up osmolarity, tonicity, haemodilution and clotting

The last two are quite important when it comes to IV fluids in trauma resuscitation

[ERDoc]

JP, sterile water is for injection once you have used it to dilute something to get the right osmolarity. If you have someone who is hypernatremic you give D5W or a sodium chloride solution, which will dilute the Na. Giving a water infusion will cause hemolysis. Are you thinking of hypertonic saline for hyponatremia?

[JPINFV]

No, more of mis recalled something as stated. Probably a bit to do with discussing free water deficit, 0.45%NaCL, D5w, and enteral water replacement in a short amount of space.

Edited October 16, 2011 by JPINFV

[ERDoc]

I hear you. All of that chemistry crap starts to blend into one. Nephrology sucks, lol.