super helpful, this is the best summary of fluids I've come across! one pearl I learned recently is D51/2NS is apparently the most ideal choice for rehydration in sickle cell criss
Another consideration is fluid compatibility. Some medications may not be compatible with the fluid you choose, especially when it comes to antibiotics, some of which need to be infused over hours, and therefore too slowly to be used as a maintenance rate. Pharmacy may not catch this as they may not know what is infusing through which IV line.
Hey dr Conan !!! I loved your video a lot. I was wondering what are the actual risk in using LR in acute liver failure. Do patient get Lactic build up ?? there were some RCT's that did not show significant risk with using LR in those patient but I still hear that it is generally avoided. What is your opinion as a clinician ?
While yes, impaired liver function can reduce clearance of lactic acid - I would 100% favor LR over NS in these patients. The lactate content is really quite miniscule, and I'd be more worried about inducing hyperchloremic metabolic acidosis with NS than with LR. Of course, either way you'd need to be pretty cautious with fluid use in a patient with acute liver failure since it will be quite easy to overload them if you aren't careful.
super helpful, this is the best summary of fluids I've come across! one pearl I learned recently is D51/2NS is apparently the most ideal choice for rehydration in sickle cell criss
Including relevant trials is very helpful, thanks!
New PGY2, loving your videos to refresh/organize my thoughts when teaching the interns!
Another consideration is fluid compatibility. Some medications may not be compatible with the fluid you choose, especially when it comes to antibiotics, some of which need to be infused over hours, and therefore too slowly to be used as a maintenance rate. Pharmacy may not catch this as they may not know what is infusing through which IV line.
Hi Dr. Liu, Thanks for the great videos. Can you please do one on DKA diagnosis and management in the hospital Thanks.
Amazing video, do you think hospitals jobs will be saturated in 7 to 10 years?
Thank you so much 🙏🙏🙏
Thanks!
Hey dr Conan !!! I loved your video a lot. I was wondering what are the actual risk in using LR in acute liver failure. Do patient get Lactic build up ?? there were some RCT's that did not show significant risk with using LR in those patient but I still hear that it is generally avoided. What is your opinion as a clinician ?
While yes, impaired liver function can reduce clearance of lactic acid - I would 100% favor LR over NS in these patients. The lactate content is really quite miniscule, and I'd be more worried about inducing hyperchloremic metabolic acidosis with NS than with LR. Of course, either way you'd need to be pretty cautious with fluid use in a patient with acute liver failure since it will be quite easy to overload them if you aren't careful.
Hi. Doctor,
Can 0.9 sodium chloride IV cause chills and increse Heart Rate ? Thx 🙏
No, not that I am aware of
I think it’s just the ‘coolness’ of the fluid sometimes. Some on my patients complain of this feeling.
I order fluids by "dose" (bag), so I can count forward in liters my "end time"
Thank you...thank you. This is one of the best summary of IV fluids. Thank you
Perfect explanation. Easy to understand yet full of great info.
Conan!!
Trackstar!! :)
This is so needed, thank you so much!!! I’m about to start clinicals and I am terrified 🥲