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Normal Saline 0.9% ✅
Related Subjects: |Respiratory Failure |Non-invasive ventilation (NIV) |Intubation and Mechanical Ventilation |Critical illness neuromuscular weakness |Haemodialysis |Dobutamine |Metabolic acidosis
0.9% Sodium Chloride (Normal Saline) – standard crystalloid for fluid resuscitation. It is isotonic but not physiologically “normal” (chloride higher than plasma). Always check the BNF here before prescribing.
⚗️ Composition
- Sodium: 150 mmol/L
- Chloride: 150 mmol/L
- Osmolality: ~308 mOsm/L
- pH: ~5.0–5.5 (acidic)
- No glucose, no buffer
📌 Indications (NICE-aligned)
- Initial resuscitation in shock (septic, hypovolaemic, trauma, peri-arrest)
- Acute surgical hypovolaemia
- Rapid intravascular volume expansion where balanced crystalloids unavailable
⚠️ Side Effects / Considerations
- Large volumes (>4 L/day) → hyperchloraemic metabolic acidosis
- Can reduce renal perfusion → decreased urine output
- Dilutional electrolyte disturbances, especially with concurrent blood transfusion
- Monitor Na⁺, K⁺, Cl⁻, and acid-base status in prolonged therapy
🚫 Contraindications / Cautions
- Heart failure / renal impairment: risk of fluid overload, pulmonary oedema
- Liver disease: sodium load may worsen ascites/edema
- Use balanced crystalloids (Hartmann’s, Plasma-Lyte) if prolonged resuscitation or risk of acidosis
🌟 Teaching Pearls
Despite the name “normal” saline, it is not identical to plasma. High chloride content → risk of metabolic acidosis, particularly in ICU patients. Think of it as a “workhorse” for rapid resuscitation, but prefer balanced fluids for maintenance or prolonged therapy. Always individualize based on patient comorbidities (renal, cardiac, liver) and electrolyte status.
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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