Sodium chloride isotonic saline

Sodium chloride (normal saline)- 0.9% Sodium chloride (normal saline), which is isotonic, restores both water and sodium chloride losses. Other indications for parenteral 0.9% saline include Diluting or dissolving drugs for IV, IM, or subcutaneous injection flushing of IV catheters extracellular fluid replacement treatment of metabolic alkalosis in the presence of fluid loss and mild sodium depletion as a priming solution in hemodialysis procedures and to initiate and terminate blood transfusions without hemolyzing red blood cells. 

Isotonic crystalloids, such as 0.9% sodium chloride (normal saline) or lactated Ringer s solution, are used commonly for fluid resuscitation. A patient in septic shock typically requires up to 10 L of crystalloid solution during the first 24-hour period. These solutions distribute into the extracellular compartment. Approximately 25% of the infused volume of crystalloid remains in the intravascular space, whereas the balance distributes to extravascular spaces. Although this could impair diffusion of oxygen to tissues, clinical impact is unproven. 

Ophthalmic Dosage Forms. Ophthalmic preparations can be solutions, eg, eye drops, eyewashes, ointments, or aqueous suspensions (30). They must be sterile and any suspended dmg particles must be of a very fine particle size. Solutions must be particle free and isotonic with tears. Thus, the osmotic pressure must equal that of normal saline (0.9% sodium chloride) solution. Hypotonic solutions are adjusted to be isotonic by addition of calculated amounts of tonicity adjusters, eg, sodium chloride, boric acid, or sodium nitrate. 

Fluids can be classified further according to their tonicity. Isotonic solutions (i.e., normal saline or 0.9% sodium chloride [NaCl]) have a tonicity equal to that of the ICF (approximately 310 mEq/L or 310 mmol/L) and do not shift the distribution of water between the ECF and the ICF. Because hypertonic solutions (i.e., hypertonic saline or 3% NaCl) have greater tonicity than the ICF (greater than 376 mEq/L or 376 mmol/L), they draw water from the ICF into the ECF. In contrast, hypotonic solutions (i.e., 0.45% NaCl) have less tonicity than the ICF (less than 250 mEq/L or 250 mmol/L) leading to an osmotic pressure gradient that pulls water from the ECF into the ICF. The tonicity, electrolyte content, and glucose content of selected fluids are shown in Table 24—3. 

Commonly administered LVPs include such products as Lactated Ringers Injection USP, Sodium Chloride Injection USP (0.9%), which replenish fluids and electrolytes, and Dextrose Injection USP (5%), which provides fluid plus nutrition (calories), or various combinations of dextrose and saline. In addition, numerous other nutrient and ionic solutions are available for clinical use, the most popular of which are solutions of essential amino acids or lipid emulsions. These solutions are modified to be hypertonic, isotonic, or hypotonic to aid in maintaining both fluid, nutritional, and electrolyte balance in a particular patient according to need. Indwelling needles or catheters are required in LVP administration. Care must be taken to avoid local or systemic infections or thrombophlebitis owing to faulty injection or administration technique. 

Whereas isotonic saline (0.9% sodium chloride) is nontoxic to the cornea and conjimctiva, sodium chloride, especially at the 5% concentration, can cause discomfort on instillation. Stinging, burning, and irritation are common complaints, but patients generally tolerate the therapy, especially if vision is improved. Epistaxis has been associated with use of 2% sodium chloride solution. The solution formulation should not be used if it changes color or becomes cloudy. 

Intravenous fluid and electrol3rtes. Patients are often more deficient in water than in saline and although initial replacement is by isotonic (0.9%) sodium chloride solution, occurrence of h5rper-natraemia is an indication for half isotonic (0.45%) solution. A patient with diabetic ketoacidosis may have a fluid deficit of above 5 litres and may be given ... 

Regardless of the manner of presentation, the initial management is the same. If the patient presents with mental status changes (e.g. decreased consciousness), an oral airway must be secured in the immediate instance. Volume status should be assessed and isotonic saline administered for volume repletion. A serum lithium level and a serum chemistry panel (serum sodium, potassium, chloride, CO2, BUN and creatinine, and calcium) should be drawn immediately to assess... 

Isotonic saline contains 0.9% w/v of sodium chloride (mol. wt. = 58.5). Express the concentration of this solution as (a) molarity (b) molality (c) mole fraction and (d) milliequivalents of Na" per litre. Assume that the density of isotonic saline is 1 g cm... 

Dimethyl sulfoxide (DMSO) has also been suggested as a potent osmotic diuretic in horses. However, one study that compared the diuretic effects of DMSO with furosemide (frusemide, Img/kg) and hypertonic saline (5 liters) found that DMSO (Ig/kg administered i.v. diluted in 5 liters of 0.9% sodium chloride) was a relatively weak diuretic agent that doubled 4-h urine production in comparison with that achieved with the same volume of isotonic (0.9%) sodium chloride. The most dramatic diuretic response was produced by the hypertonic saline (7.5%), which resulted in the production of more than 40 ml/kg urine during the first 4-h period after administration (Schott Black 1995). 

Aggressive treatment requires administering an antimicrobial medication intravenously (IV). The antimicrobial medication is diluted in a neutral solution (pH 7.0 to 7.2), such as normal saline (NS), isotonic sodium chloride, or 5% dextrose and water (D5W). Antimicrobial medication can be administered as a piggyback infusion. 

Unfortunately, beneficial outcome data attributable to administration of these hypertonic solutions also have been lacking. Most of these studies were conducted in prehospital and emergency department settings using 250 mL 7.5% sodium chloride with or without 6% dextran-70. A meta-analysis of randomized, controlled trials found no statistical difference between the survival rates of patients receiving the hypertonic saline solutions and those receiving standard isotonic crystalloid solutions.Part of the explanation for this finding may... 

E. Begin intravenous infusion of normal saline (NS), 5% dextrose in NS (DSNS), 5% dextrose in half NS (D5W 0.45% sodium chloride), or 5% dextrose in water (D5W) at a keep-open rate for children, use 5% dextrose in quarter NS (D5W 0.25% sodium chloride). If the patient is hypotensive (see p 16), NS or another isotonic crystalloid solution is preferred. 

So why do some ionic EAPs contract The movement of the ions of the electrolyte comes into play, but to exploit contraction, the placement of the electrodes is also very important. If contraction, rather than bending is desired, the negative electrode is placed external to the EAP, while the positive electrode remains internal (embedded) in the EAP (Fig. 4.5). In the case of the contractile EAP composed of PMA, the ions along the main polymer chains are weak acetic acid groups. The electrolytic solution typically used to swell the gel and provide for good electroactivity is a dilute sodium chloride solution, such as isotonic saline solution. When the electric input is applied to the PMA EAP based actuator with this electrode configuration, the EAP of the actuator contracts quickly and substantially. In selected EAP formulations, when the polarity is reversed, expansion occurs, and contraction and expansion can be cycled repeatedly in selected PMA based EAP materials and actuators [3, 5]. 

OK - you say to yourself, while composing your thoughts - isotonic saline solution, that is, 0.9% solution of sodium chloride, NaCl, in water. And - from the days of... 

A 0.90% (0.15 M) sodium chloride solution is known as a physiological saline solution because it is isotonic with blood plasma that is, it has the same concentration of NaCl as blood plasma. Because each mole of NaCl yields about 2 mol of ions when in solution, the solute particle concentration in physiological saline solution is nearly 0.30 M. Five-percent-glucose solution (0.28 M) is also approximately isotonic with blood plasma. Blood cells neither swell nor shrink in an isotonic solution. The cells described in the preceding paragraph swell in water because water is hypotonic to cell plasma. The cells shrink in 5%-urea solution because the urea solution is hypertonic to the cell plasma. To prevent possible injury to blood cells by osmosis, fluids for intravenous use are usually made up at approximately isotonic concentration. 

Why don t blood cells shrink or swell in an isotonic sodium chloride solution (0.9% saline) ... 

Some of the best examples of osmosis are those associated with living organisms. For instance, if red blood cells are placed in pure water, the cells expand and eventually burst as a result of water that enters through osmosis. The osmotic pressure associated with the fluid inside the cell is equivalent to that of 0.92% (mass/volume) NaCl(aq). Thus, if cells are placed in a sodium chloride (saline) solution of this concentration, there is no net flow of water through the cell membrane, and the cell remains stable. Such a solution is said to be isotonic. If cells are placed in a solution with a concentration greater than 0.92% NaCl, water flows out of the cells, and the cells shrink. Such a solution is said to be hypertonic. If the NaCl concentration is less than 0.92%, the solution is hypotonic, and water flow s into the cells. Fluids that are intravenously injected into patients to combat dehydration or to supply nutrients must be adjusted so that they are isotonic with blood. The osmotic pressure of the fluids must be the same as that of 0.92% (mass/volume) NaCl. 

Normal saline is an isotonic fluid composed of water, sodium, and chloride. It provides primarily ECF replacement and can be used for virtually any cause of TBW depletion. Common uses of normal saline include perioperative fluid administration volume resuscitation of shock, hemorrhage, or burn patients fluid challenges in hypotensive or oliguric patients and hyponatremia. 

It will be apparent that if normal extracellular fluids were subjected to an isotonic resorption of sodium and chloride ions by the process, the net effect would be to concentrate other ions and precipitate minerals. This suggestion was made613 to explain one of the methods of forming deposits in the calciferious glands of earthworms. It was proposed that the posterior glands received blood directly from the intestine. Fluid was formed in these glands by a process of filtration and saline was then resorbed by the epithelial cells. This resulted in the formation of calcareous deposits (Fig. 5). 

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