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Specific replacement fluids of specific losses

  1. Gastric fluid (nasogastric tube, emesis) Dextrose/Saline with 20 mEq/litre KCl; replace equal volume of lost fluid q6h

  2. Diarrhoea Ringers Lactate with 15 mEq/litre KCl. Provide 1 litre replacement for each 1 kg or 2.2 lb of lost body weight; bicarbonate 45 mEq(1/2 amp) per litre may be added

  3. Bile D5LR with 25 mEq/litre (1/2 amp) of bicarbonate

  4. Pancreatic D5LR with 50mEq/litre (1 amp) bicarbonate

Types of Fluids

Type Na \ensuremath{^+} K \ensuremath{^+} Cl \ensuremath{^-} HCO \ensuremath{_3^-} Ca \ensuremath{^{2+}} Glucose
Normal Saline N/S 0.9% 150 0 150 0 0 0
Hartman's 131 5 111 29 2 0
Dextrose Saline D/S / solution 18 30 0 30 0 0 43 g/L
Dextrose 5% 0 0 0 0 0 50 g/L

NOTE The common regime of Hartman's 8 hourly give EXCESS Na \ensuremath{^+}. We tend to be more generous than 3L/24 hours regime

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Adrian P. Ireland