Not all saline bottles you see hanging on the beside are the same. There are different types of Rehydration Solutions and different uses for each of them. This article discusses the contents and indications for each of those saline types.

Intravenous Solutions (IV Fluids) play a pivotal role in medical care, offering a rapid and efficient means to rehydrate patients facing oral intake challenges or severe dehydration. These solutions feature a meticulously calibrated blend of water, electrolytes, and additional nutrients, administered directly into the bloodstream through a cannula.

Types of IV Fluids

Crystalloids

Normal Saline

Normal saline solution, also known as 0.9% sodium chloride solution, is the most commonly used IV hydration solution. It contains sterile water and a specific amount of sodium chloride (salt) to match the concentration of electrolytes found in the body. This solution is employed to replenish fluid volume and restore electrolyte balance in patients experiencing dehydration resulting from vomiting, diarrhea, excessive sweating, or other conditions leading to fluid loss.

Normal saline solution is isotonic, meaning it has the same concentration of electrolytes as the body’s extracellular fluid. It is also used to dilute medications and flush intravenous catheters. However, in some cases, excessive use of normal saline can lead to hypernatraemia.

Component	Normal Saline (0.9% NaCl)	Normal Body Fluid Osmolality
Sodium (Na+)	154 mmol/L	135-145 mmol/kg
Chloride (Cl-)	154 mmol/L	98-106 mmol/kg
Osmolality	Approximately 308 mOsm/kg	Approximately 280-295 mOsm/kg
pH	Around 5.0-7.0	Approximately 7.35-7.45

Dextrose Solution

Dextrose solution, commonly referred to as glucose solution, constitutes a form of IV hydration solution containing dextrose, a readily absorbed simple sugar. Healthcare providers typically use it alongside other solutions. They do this to provide energy and stabilize blood sugar levels in patients unable to consume fluids orally due to illness, surgery, or other medical causes.

Dextrose solution comes in different concentrations, ranging from 5% to 70%. The concentration used depends on the patient’s medical condition and nutritional needs. Dextrose solution may induce hyperglycemia (high blood sugar) in certain patients. This necessitates cautious use in individuals with diabetes or other conditions impacting blood sugar levels.

Component	Dextrose Solution (5% Dextrose)	Normal Body Fluid Osmolality
Dextrose (glucose)	50 g/L (approximately 278 mmol/L glucose)	–
Osmolality	Approximately 252 mOsm/kg	Approximately 280-295 mOsm/kg
pH	4.5-7.0 (depends on formulation)	Approximately 7.35-7.45

Hartmann’s Solution

Hartmann’s solution, also known as lactated Ringer’s solution, is a type of intravenous (IV) hydration solution. It contains a combination of electrolytes and lactate. This solution is commonly used in medical settings. It aims to replace fluids and electrolytes lost due to dehydration, blood loss, or other medical conditions.

Here are the different types of Hartmann’s solution and their specific compositions:

Standard Hartmann’s Solution

Standard Hartmann’s solution contains sodium chloride, potassium chloride, calcium chloride, and sodium lactate in a specific concentration. The electrolytes in this solution help to restore fluid balance and maintain proper pH levels in the body. In addition, Sodium lactate also helps to buffer excess acid in the body.

The composition of standard Hartmann’s solution is as follows:

Modified Hartmann’s Solution

Modified Hartmann’s solution, also known as lactated Ringer’s acetate solution, is a variation of standard Hartmann’s solution that replaces sodium lactate with sodium acetate. This modification aims to provide better metabolic support to critically ill patients, especially those with liver disease.

The composition of modified Hartmann’s solution is as follows:

Hypertonic Hartmann’s Solution

Hypertonic Hartmann’s solution is a variation of standard Hartmann’s solution that contains a higher concentration of electrolytes. This solution is employed to address severe dehydration or hyponatremia (low sodium levels in the blood). Its administration requires close medical oversight due to the elevated concentration of electrolytes, which can potentially lead to complications in certain patients.

Albumin Solution

Albumin solution is a type of IV fluids that contains a protein called albumin. Healthcare providers use this solution to treat patients who have lost large amounts of blood or fluids due to trauma, surgery, or other medical conditions. Albumin helps to increase the volume of blood plasma, which can help to maintain blood pressure and improve organ function.

Albumin solution comes in different concentrations, ranging from 5% to 25%. The concentration used depends on the patient’s medical condition and nutritional needs. Albumin solution may elicit allergic reactions in certain patients, necessitating cautious use, especially in individuals with liver or kidney disease.

Colloids

Total Parenteral Nutrition (TPN)

Healthcare providers use this solution for patients unable to ingest food or fluids due to various medical conditions. These conditions include illness, surgery, or other health reasons.ns. Furthermore, Total Parenteral Nutrition (TPN) consists of a balanced blend of carbohydrates, proteins, fats, electrolytes, vitamins, and minerals. This blend is custom-tailored to meet each patient’s unique requirements. Typically, it is administered through a central vein, like the subclavian or jugular vein, necessitating meticulous supervision by healthcare personnel.

TPN finds application in patients with impaired digestive systems, such as individuals afflicted with short bowel syndrome, severe inflammatory bowel disease, or specific cancer types. Additionally, it serves patients enduring prolonged periods of fasting due to other medical ailments like burns or severe infections.

Other IV solutions

Banana Bag

The term “banana bag” describes a particular type of IV fluids comprising a blend of vitamins and minerals. It earns its moniker “banana” bag due to its yellow hue, reminiscent of the color of a banana.

The composition of a banana bag typically includes the following:

Electrolyte	Concentration (mmol/L)
Sodium Chloride (NaCl)	20
Potassium Chloride (KCl)	20
Magnesium Sulfate (MgSO4)	8
Calcium Gluconate (CaGlu)	10
Dextrose (glucose)	5
Thiamine (vitamin B1)	100 mg
Folic Acid	1 mg
Multivitamins	As per formulation

Thiamine (vitamin B1)

Thiamine is a crucial vitamin that helps the body convert food into energy. In banana bags, healthcare providers frequently use it to prevent Wernicke-Korsakoff syndrome, a condition commonly observed in alcoholics and characterized by confusion, memory loss, and other neurological symptoms.

Folate (vitamin B9)

Folate is an essential vitamin that helps the body produce new cells. Healthcare providers commonly include it in banana bags to treat folate deficiency anemia.

Magnesium

Magnesium is an essential mineral that helps regulate nerve and muscle function, blood sugar levels, and blood pressure. It is commonly used in banana bags to treat magnesium deficiency, which can cause muscle cramps, weakness, and other symptoms.

Multivitamins

Banana bags also typically contain a mixture of other vitamins, including vitamin B12, vitamin C, and vitamin K. These vitamins help support overall health and can prevent deficiencies that can lead to other medical problems.

In medical settings, healthcare providers commonly administer banana bags to treat patients with alcoholism, malnutrition, or other medical conditions that may induce nutrient deficiencies. Additionally, they use them to address fluid and electrolyte imbalances in patients recovering from surgery or other medical procedures.