Hypertonic solutions

• 3% Saline.
• 5% Saline.
• 10% Dextrose in Water (D10W)
• 5% Dextrose in 0.9% Saline.
• 5% Dextrose in 0.45% saline.
• 5% Dextrose in Lactated Ringer’s.

Hypertonic solutions have a higher concentration of dissolved particles than blood. An example of hypertonic IV solution is 3% Normal Saline (3% NaCl). When infused, hypertonic fluids cause an increased concentration of dissolved solutes in the intravascular space compared to the cells.

hypotonic: Having a lower osmotic pressure than another; a cell in this environment causes water to enter the cell, causing it to swell. hypertonic: having a greater osmotic pressure than another. isotonic: having the same osmotic pressure.

Hypotonic solutions have more water than a cell. Tapwater and pure water are hypotonic. A single animal cell ( like a red blood cell) placed in a hypotonic solution will fill up with water and then burst. This is why putting water on a bloodstained piece of clothing makes the stain worse.

Normal saline solution (0.9% NaCl) or NSS, is a crystalloid isotonic IV fluid that contains water, sodium (154 mEq/L), and chloride (154 mEq/L).

Compared with isotonic saline, hypertonic saline nasal irrigation for the treatment of chronic rhinosinusitis is significantly more effective and has mild side effects in improving nasal symptoms and ciliary movement, but there is no significant difference in imaging findings and smell improvement.

Administration

1. 3% Saline is the preferred solution.
2. 6ml / kg raises the serum sodium approximately 5 mmol/l.
3. Infusion rate: 3% Saline at 0.5 – 1.0 ml/kg/hr (max rate 100ml/hr)
4. Duration: administer over 1 hour.
5. Check serum Na hourly while infusion being administered and one hour post-completion of infusion.

Critically ill patients may receive hypertonic saline for a variety of indications, and numerous drug information resources recommend that the solution be administered via a central catheter.