Fluid	Type	Na+ (mEq/L)	Cl- (mEq/L)	K+ (mEq/L)	Osm (mOsm/L)	Tonicity
0.9% Normal Saline	Crystalloid	154	154	0	308	Isotonic
Lactated Ringer's	Crystalloid	130	109	4	273	Isotonic
Plasma-Lyte 148	Crystalloid	140	98	5	295	Isotonic
5% Dextrose in Water (D5W)	Crystalloid	0	0	0	252	Hypotonic
0.45% NaCl (Half Normal Saline)	Crystalloid	77	77	0	154	Hypotonic
3% Hypertonic Saline	Crystalloid	513	513	0	1026	Hypertonic
D5 0.45% NaCl (D5 1/2 NS)	Crystalloid	77	77	0	406	Hypertonic
D5 0.9% NaCl (D5NS)	Crystalloid	154	154	0	560	Hypertonic
10% Dextrose in Water (D10W)	Crystalloid	0	0	0	505	Hypertonic
5% Albumin	Colloid	145	145	1	300	Isotonic
25% Albumin	Colloid	145	145	1	300	Hypertonic
Normosol-R	Crystalloid	140	90	5	295	Isotonic
D5 0.225% NaCl (D5 1/4 NS)	Crystalloid	38.5	38.5	0	329	Isotonic
D5 Lactated Ringer's (D5LR)	Crystalloid	130	109	4	525	Hypertonic
50% Dextrose in Water (D50W)	Crystalloid	0	0	0	2525	Hypertonic
Isolyte S	Crystalloid	141	98	5	295	Isotonic
5% Hypertonic Saline	Crystalloid	855	855	0	1710	Hypertonic
Isotonic Sodium Bicarbonate (1.3%)	Crystalloid	150	0	0	300	Isotonic
6% Hetastarch (Hespan)	Colloid	154	154	0	309	Isotonic
10% Dextran 40	Colloid	154	154	0	300	Isotonic

0.9% Normal SalinepH 5.5

Indications

Fluid resuscitation, Hyponatremia, Blood transfusions, Metabolic alkalosis

Clinical Pearl

"Despite the name 'normal', it contains significantly more chloride than plasma (154 vs 100 mEq/L)."

Lactated Ringer'spH 6.5

Indications

Fluid resuscitation, Surgical fluid replacement, Burn resuscitation, Acidosis (lactate acts as buffer)

Clinical Pearl

"Preferred over NS for large volume resuscitation to avoid hyperchloremic acidosis."

Plasma-Lyte 148pH 7.4

Indications

Fluid resuscitation, Maintenance fluid, Alternative to LR/NS

Clinical Pearl

"Excellent choice for massive transfusions or when pH balance is critical."

5% Dextrose in Water (D5W)pH 4.5

Indications

Hypernatremia, Provision of free water, Hypoglycemia, Drug diluent

Clinical Pearl

"Isotonic in the bag, but rapidly becomes hypotonic in the body as dextrose is metabolized."

0.45% NaCl (Half Normal Saline)pH 5.0

Indications

Hypernatremia, Diabetic Ketoacidosis (after initial resuscitation), Maintenance fluid

Clinical Pearl

"Never use as a primary resuscitation fluid because it moves rapidly into the intracellular space."

3% Hypertonic SalinepH 5.0

Indications

Severe symptomatic hyponatremia, Elevated Intracranial Pressure (ICP)

Clinical Pearl

"Should generally be infused via a central line. Monitor serum sodium very frequently (e.g. Q2-4 hours)."

D5 0.45% NaCl (D5 1/2 NS)pH 4.5

Indications

Common maintenance fluid, DKA (when glucose falls < 250 mg/dL), NPO status

Clinical Pearl

"Considered hypertonic in the bag, but acts as a hypotonic solution in the body once the dextrose is rapidly metabolized."

D5 0.9% NaCl (D5NS)pH 4.5

Indications

Shock (transiently), Addisonian crisis, SIADH (rarely)

Clinical Pearl

"Useful in patients needing both volume expansion and calories, though rarely a first-line choice over plain NS/LR for resuscitation."

10% Dextrose in Water (D10W)pH 4.3

Indications

Severe hypoglycemia, Peripheral TPN/PPN base, Neonatal maintenance

Clinical Pearl

"Max concentration of dextrose generally recommended for peripheral IV administration to avoid phlebitis."

5% AlbuminpH 6.9

Indications

Hypovolemia (when crystalloids fail or require massive volume), Burns (after 24 hours), Hypoproteinemia

Clinical Pearl

"Acts as a powerful volume expander; 500 mL of 5% albumin expands plasma volume by ~500 mL."

25% AlbuminpH 6.9

Indications

Large volume paracentesis, Severe hypoalbuminemia with edema, Hepatorenal syndrome

Clinical Pearl

"100 mL of 25% albumin expands intravascular volume by 400-500 mL by pulling in interstitial fluid. Do not use for acute resuscitation without crystalloid support."

Normosol-RpH 7.4

Indications

Replacement of acute fluid losses, Surgery

Clinical Pearl

"Very similar to Plasma-Lyte 148; excellent choice for patients with liver dysfunction who cannot metabolize lactate."

D5 0.225% NaCl (D5 1/4 NS)pH 4.5

Indications

Pediatric maintenance fluid, Neonatal maintenance fluid

Clinical Pearl

"Historically used in pediatrics, but recent guidelines prefer isotonic fluids (like NS or LR) to prevent hospital-acquired hyponatremia."

D5 Lactated Ringer's (D5LR)pH 5.0

Indications

Post-operative fluid maintenance, Provide calories and balanced electrolytes

Clinical Pearl

"Acts like Lactated Ringer's once the dextrose is metabolized, making it an excellent isotonic replacement with added calories."

50% Dextrose in Water (D50W)pH 4.2

Indications

Severe acute hypoglycemia (Code), Hyperkalemia (given with insulin)

Clinical Pearl

"Given as an IV push (usually 50 mL ampule = 25 grams of dextrose). Ensure IV patency before pushing."

Isolyte SpH 7.4

Indications

Volume resuscitation, Maintenance fluid

Clinical Pearl

"Uses acetate and gluconate as buffers, avoiding the lactate metabolism required by LR."

5% Hypertonic SalinepH 5.0

Indications

Refractory elevated Intracranial Pressure (ICP)

Clinical Pearl

"Must be given via a central line. Typically reserved for critical care settings for traumatic brain injury."

Isotonic Sodium Bicarbonate (1.3%)pH 8.0

Indications

Severe metabolic acidosis, Toxicology (tricyclic antidepressant overdose), Urine alkalinization

Clinical Pearl

"Often compounded by mixing 3 ampules of 8.4% Sodium Bicarbonate into 1 liter of D5W."

6% Hetastarch (Hespan)pH 5.5

Indications

Hypovolemia (historical use)

Clinical Pearl

"Largely abandoned in modern critical care due to risks of coagulopathy and acute kidney injury."

10% Dextran 40pH 4.5

Indications

Prophylaxis of venous thrombosis, Volume expansion (historical)

Clinical Pearl

"Rarely used for volume expansion today; primarily used in vascular surgery to maintain graft patency."