Normal Saline


Indications

Intravenous (IV)

Hypovolemic Hyponatremia (see Hyponatremia)

  • Clinical Efficacy
    • Single-Center, Multiple-Crossover SALT-ED Trial of Balanced Crystalloids vs Normal Saline in Non-Critically Ill Adults in the Emergency Department (NEJM, 2018) [MEDLINE]: n = 13,347
      • Among noncritically ill adults treated with intravenous fluids in the emergency department, there was no difference in hospital-free days between treatment with balanced crystalloids and treatment with saline

Anaphylaxis (see Anaphylaxis)

  • Clinical Efficacy

Hemorrhagic Shock (see Hemorrhagic Shock)

  • Clinical Efficacy

Hypovolemia/Hypovolemic Shock (see Hypovolemic Shock)

  • Clinical Efficacy
    • Single-Center, Multiple-Crossover SALT-ED Trial of Balanced Crystalloids vs Normal Saline in Non-Critically Ill Adults in the Emergency Department (NEJM, 2018) [MEDLINE]: n = 13,347
      • Among noncritically ill adults treated with intravenous fluids in the emergency department, there was no difference in hospital-free days between treatment with balanced crystalloids and treatment with saline

Sepsis (see Sepsis)

  • Clinical Efficacy
    • Cluster-Randomized, Multiple-Crossover SMART-MED and SMART-SURG Trial of Balanced Crystalloids vs Normal Saline in Critically Ill Adults (NEJM, 2018) [MEDLINE]: n = 7942 (5 ICU’s)
      • Balanced Crystalloids (Lactated Ringers or Plasma-Lyte) for Intravenous Fluid Resuscitation Decreased the Composite Outcome of All-Cause Mortality Rate, Need for New Renal Replacement Therapy, and Persistent Renal Dysfunction, as Compared to Normal Saline

Subcutaneous (SQ)

Other

  • Nasal Irrigation: in the setting of sinusitis
  • Ocular Irrigation: in the setting of ocular exposures
  • Wound Irrigation: does not burn or sting when used

Pharmacology

Definitions

History of Crystalloids

Balanced vs Unbalanced Crystalloids

Composition of Various Intravenous Fluids


Administration


Adverse Effects

Cardiovascular Adverse Effects

Renal Adverse Effects

Other Adverse Effects


References