This PPT gives an idea to MBBS students about the Type of fluids, Calculating the daily requirements as well as the drop rate to be used in day today clinical practice.

1. Dr. U.Murali.M.S;M.B.A.
Professor of Surgery

2. Introduction
 Intravenous fluids are chemically prepared
solutions that are administered to the patient.
 They are tailored to the body’s needs and used
to replace lost fluid and/or aid in the delivery of
IV medications.

3. Indications
 For rapid restoration of fluid and electrolytes in
dehydration due to vomiting, diarrhoea, shock due
to haemorrhage or sepsis or burns.
 Total parenteral nutrition.
 Anaphylaxis, cardiac arrest, hypoxia.
 Post gastrointestinal surgeries.
 For maintenance, replacement of loss or as a special
fluid.

4. Advantages
 Provides the patient with life-sustaining fluids,
electrolytes, and drugs.
 Immediate and predictable therapeutic effects.
 Preferred for administering fluids, electrolytes, and
drugs in emergency situations.
 Allows fluid intake when a patient has GI
malabsorption.
 Permits accurate dosage titration for analgesics and
other drugs.

5. Disadvantages
 Needs hospitalisation, costly.
 Infection.
 Pyrogenic reaction.
 Discomfort, poor patient compliance.
 Fluid overload – chances.

6. Electrolyte Requirements –
Daily
 Na+ 50 – 90 mmol / day
 K+ 50 mmol / day
 Ca+ 5 mmol / day
 Mg+ 1 mmol /day

7. IV Fluid ?
 The majority of an IV solution is sterile water.
 Chemically, water is referred to as a “solvent.” A
solvent is a substance that dissolves other
materials called “solutes.”
 Within IV solutions, the solutes can be molecules
called electrolytes or other larger compounds such
as proteins or molecules.

8. Daily Requirements
Maintenance Fluid formula
4 ml/kg/h for the first 10 kg
2 ml/kg/h for the next 10 kg
1 ml/kg/h for every kg over 20 kg
Therefore a 70 kg patient using the calculation:
40+20+50=110
will require 110 ml/h

9. Intra venous Fluids
IV fluids come in four different forms:
Colloids
Crystalloids
Blood and blood products

10. Colloid Solutions
 Colloid solutions are IV fluids containing large proteins and
molecules that tend to stay within the vascular space (blood
vessels).
 They shift the fluids from interstitial to intravascular compt.
 Colloids are useful in maintaining blood volume. Colloids are
expensive, have specific storage requirements, and have a short
shelf life.
 Commonly used colloid solutions include plasma protein
fraction, salt poor albumin, dextran.

11. Crystalloid Solutions
 Crystalloid solutions are the primary fluid used for IV therapy.
Crystalloids contain electrolytes but lack the large proteins and
molecules found in colloids.
 Crystalloids come in many preparations and are classified
according to their “tonicity.”
 A crystalloid’s tonicity describes the concentration of
electrolytes (solutes) dissolved in the water, as compared with
that of body plasma.

12. Isotonic
Isotonic crystalloids have
a tonicity that is equal to
the plasma in the body.
The fluid will distribute
evenly between the
intravascular space and
cells.
5% dextrose in H2O
(D5W)
Lactated Ringers /
0.9% NaCL or Normal
saline (NS)

13. Hypotonic
 Hypotonic crystalloids
have a tonicity lower
than the body plasma.
 Shift from the
intravascular space to
the extravascular space,
and eventually into the
tissue cells.
 0.45% Na CL or half
normal saline
 Used for dehydration

14. Hypertonic
Hypertonic crystalloids have
a tonicity higher than the
body plasma.
 The administration of a
hypertonic crystalloid
causes water to shift from
the extravascular spaces
into the bloodstream,
increasing the intravascular
volume.
5% dextrose in 0.45% NaCl
(D5 ½ NS)

15. Commonly used fluid
 Lactated Ringer’s (LR) is an isotonic crystalloid
that contains sodium chloride, potassium
chloride, calcium chloride, and sodium lactate in
sterile water.
 Normal saline solution (NSS) is an isotonic
crystalloid that contains 0.9% sodium chloride
(salt) in sterile water.
 5% Dextrose in water (D5W) is packaged as an
isotonic carbohydrate (sugar solution) that
contains glucose (sugar) as the solute which is
used by the cells to create energy.

16. Calculation – Drop rate
 1ml = 16 drops For microdrip set 1ml = 60 drops.
 A. QOF required in liters / day x 10 = Drop rate / mt
( 2.5 l is quantity of fluid / day. So 2.5 x 10 = 25 drops / mt )
 B. Fluid to be infused in 1 hour divided by 4 = Drops / mt.
 C. No. of microdrop / mt = volume in ml / hr

17. Summary
 There are several different types of fluids used for IV
therapy.
 Depending on their specific type and makeup, IV
fluids can cause the shift between the intracellular
and extracellular compartments.
 Therefore, it is important to choose the fluid most
appropriate to the patient’s needs.
 It is important to carefully examine the label on the
bag to ensure the right fluid has been selected.