EpistemisIntegrated Summary of Solutions and Safe Infusion
Quick reference tool for the clinician in order to verify the composition, in vivo osmolarity, limiting rate of administration and associated toxicities of the main hydroelectrolyte solutions.
File
| Clinical Solution | Real Osmolarity (mOsm/L) | Chlorine (mEq/L) | Infusion Limit Rate | Main Toxicities / Clinical Risks |
|---|---|---|---|---|
| 0.9% Saline Solution | 308 | 154 | No hemodynamic rate limit (R phase) | Hyperchloremic metabolic acidosis, renal vasoconstriction and reduction in GFR. |
| Lactated Ringer's | 273 | 109 | No limit (R phase); caution in rapid infusion | Risk of microclots due to calcium chelation in blood transfusion; cerebral edema in TBI. |
| Plasmalyte-148 | 294 | 98 | No hemodynamic limit | Risk of transient metabolic alkalosis due to excess acetate/gluconate conversion. |
| 3% Saline Solution | 1026 | 513 | Maximum 50-100 mL/hour (except in uncal herniation) | Osmotic Demyelination Syndrome (OSD), massive neuronal dehydration and severe hyperchloremic acidosis. |
| 5% Glucosated Whey | 278 | 0 | Adjusted according to free water deficit calculation | Acute cerebral edema in TBI due to hypoosmolarity and water diversion to the LIC; hyperglycemia and dilutional hyponatremia. |
| 20% albumin | 370 (in vivo) | Variable (120-140) | Slow; maximum 100-250 mL in a period of 1-2 hours | Sudden intravascular volume overload with imminent risk of acute pulmonary edema in heart patients. |
| Magnesium Sulfate | Hypertonic | 0 | Maximum 2 grams in 15-20 minutes (except in convulsive eclampsia) | Diffuse neuromuscular paralysis due to acetylcholine blockade, abolition of reflexes and cardiac asystole. |
| Potassium Chloride (KCl) | Highly hypertonic | Direct dissociation | Maximum 10 mEq/h peripheral; maximum 20 mEq/h central route | Hyperacute cardiac arrest in diastole refractory to rapid infusions or undiluted direct bolus. |
Epistemis is educational review material. It is not a medical device, does not diagnose or prescribe treatment, and does not replace formal medical training, current clinical guidelines, or professional clinical judgment.
- System
- Fluid therapy, Electrolytes and Acid-Base
- Cluster
- Comparative Table of Clinical Settings