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Fluid Distribution
- Only 25% of isotonic saline stays in blood vessels, expanding intravascular volume by 250 mL per liter.
- D5W distributes throughout the body, with only 8% (83 mL) remaining intravascularly.
Balanced Solutions vs. Normal Saline
- Balanced solutions like lactated ringers (LR) resemble plasma more closely than normal saline, particularly in chloride levels.
- While some trials favor LR for kidney outcomes and mortality, others show no significant difference compared to normal saline.
Colloids and Albumin
- Colloids like albumin stay intravascularly and exert oncotic pressure, drawing interstitial fluid into blood vessels.
- However, albumin's short half-life and high cost limit its advantages over isotonic fluids for resuscitation.