Crystalloid fluids

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Fluid Na Cl K Ca Mg pH Osm
Plasma 140 103 4 4 2 7.4 290
0.9% saline 154 154 5.7 308
0.45% saline 76 76 ?? 154
Ringer's lactate 130 109 4 3 6.5 273

Normal saline

  • Isotonic
  • Causes a metabolic hyperchloremic acidosis, decreasing a normal pH to 7.28 after 2L!
  • Cheapest and most widely available crystalloid

Ringer's lactate

  • Contains 28 mmol/L of lactate
  • Has no effect on acid-base status
  • Lower risk of AKI compared to normal saline when used for resuscitation

D5W

  • Provides 170kcal/L of dextrose (3L/d can protect against protein breakdown)
  • 65% moves intracellularly