IV Fluids: Lesson 2 - Crystalloids and Colloids

An overview of the differences in composition, properties, indications, and contraindications of various crystalloids and colloids, including normal saline, lactated ringers / Hartmann's solution, D5W, albumin, dextran, and hydroxyethyl starch.

[@serioustech87]

Thank you very much Eric. Wonderful lecture

[@PeeedaPan]

thank you for breaking down what components actually make up each type of fluid

[@shawnwesson1028]

InstaBlaster

[@zukisatshabalala9990]

Thanks, Eric. Am using these videos for my PA students in South Africa.

[@StrongMed]

Zukisa Tshabalala I'm glad you've found them helpful! Always great to hear from fellow educators!

[@quanphanminh293]

Great ! Thank you Dr.

[@piyushbhatt]

Thanks for such great info

[@bhaveshrathod615]

Thanks Sir. It's a great video.

[@icarosalerno]

I wonder if is there any chance to get the 4th video in this series mentioned here...thanks

[@ianshelton6662]

Can lactated ringer's be used as a maintenance fluid for patients undergoing dental sedation for an oral surgery procedure?

[@IronReef77]

Not sure if you're reading this but please, if anyone can answer this: A patient presented with Septic shock was given to me one time and was given a bolus of LR's while in the E.R. They were sent to me(ICU) still to receive LR as maintenance. But the whole issue behind Sepsis is that the tissue have a severe lack of oxygen. SO when receiving Lactate, which requires oxygen to be broken down further, yet they have low oxygen as it is, wouldn't LR be a poor choice of fluids for this pt in Septic Shock? Thank You

[@DocHemulin]

Hello Dr strong, shouldn't D5W calculated osmolarity be 277mOsm/L since glucose molecular weight is 180 g/mol?

[@devv8071]

Good analysis, can u kindly elaborate the fluid in pediatric ? As the compostition might slightly differ fr adult. About 80% water larger than adult.

[@dartosmuscle1592]

how is the 253 mosm/L is derived in D5W. ? mEq = mg/MW , mEq = 50,000mg/ 180.16grams per mol of glucose (C6H12O6) =277.53 mEq

[@RobsonVieira_-_rockbychoice_-_]

You should do a video series about hemodynamics and bedside CO monitoring too. Great work professor Eric!

[@StrongMed]

Robson Alberto Freire Vieira da Silva Thanks! Those topics are coming up - hopefully I can squeeze them in this summer.

[@mohamedbasyounyabdou3919]

Eric's Medical Lectures thank you Eric. You are beyond competition and know exactly what is annoying in medicine and make it very simple, understandable and above all memorable. please I am waiting for the 3rd and 4th video to be released soon. Again thank you very much indeed.

[@StrongMed]

Mohamed Basyouny Abdou I hope to release the 3rd and 4th videos soon, by simultaneously working on ones on shock, vasopressers, and COPD - plus others I've promised...they are definitely on their way this summer though!

[@mohamedbasyounyabdou3919]

thank you very much. I am a surgeon and gain much useful information from your topics and actually I recommend your channel to my colleagues. I am still remembering when I failed the final FRCS exam because of these areas in medicine.I like you to do a video about AKI and Fever in ICU patient

[@StrongMed]

Mohamed Basyouny Abdou Thanks for the message and suggestions! I am starting to try and coordinate my video topics to when those subjects are covered at my own medical school (with cardiology/critical care/pulm spilling into the summer). So will be covering renal in fall. Fever is a great idea too - will try to include in the not-too-distant future as well.

[@ghassandahroujDr]

Also its a good idea to discuss issues about transfusion medicine after IV fluids.

[@StrongMed]

ghassan dahrouj thanks for the suggestion! I agree that it would logically follow videos on IV fluids and shock, but transfusion medicine tentatively planned for next winter in order to coordinate with the hematology block at our med school.

[@marciagasai]

Thank you so much!

[@mustaphakamil726]

Thank you sir!

[@abdullahnafea4736]

thanks for ur great explanation. Why is LR used in hypovolemic shock (which is associated with lactic acidosis) and NOT used in other lactate accumulating conditions? If we fear worsening lactic acidosis then how come we don't consider the same problem with hypovolemia?

[@metipallearuna223]

Non intrusive practice.

[@haydenward9935]

Hello, love your videos. You state that crystalloids are superior to colloid fluids in most settings due to the listed side effects and cost of colloids. Why does Dr. Marino in the ICU handbook advocate so strongly for the use of colloid fluids in clinical settings? He asserts that colloids are fundamentally better yet your video and the articles I have read say crystalloids are better or there is no evidence that one is better. Can you elaborate?

[@MsDeenilislam]

thankyouuuu!

[@booloob]

5:48 Nacl's "van't-hoff factor" is 1.9. So 1.9 * expected osmolarity, nice & close :)

[@yoavgutt]

Hi, thank you so much for these videos! Sorry to be a nitpicker, but the Calcium normal plasma concentration you used would be right in mmol/L not mEq/mL, since calcium is a divalent ion, mEq=/= mmol, but one half of it. In mEq/mL calcium should be ~4.8 mEq/mL in the plasma (or ~9.5 mg/dL)

[@StrongMed]

Argh! Thanks for pointing that out. Darn chemistry... I've added an annotation to correct the error.

[@yoavgutt]

No problem, like many other nitpicking issues, this is probably irrelevant to patient care haha.

[@StrongMed]

Yoav Gutterman Maybe so, but I still hate mistakes in my videos!

[@naomichisanga2351]

Thanks

[@peev2]

As far as I know there is Ringer's solution with no lactate, which is different then LR, and LR=Hatmann.

[@HafizahHoshni]

Thank youuu so much!!!

[@AmrALridi]

Very intersting thank u (please need pdf for lecture❤

[@juliachambers725]

Where does plasmalyte fits?

[@user-wr9ks3tf4n]

Hi doctor, where is the fourth video of this series, thank you.

[@StrongMed]

I'm so sorry, I literally just never got around to it.

[@serioustech87]

Awe, I wanted the lecture to continue with why Colloids cause the side effects that they do.....Haha, anyways, thanks again.

[@StrongMed]

Jayson Huffman Will actually probably cover that in the next lecture on using fluids in resuscitation.