Which medications in the drug class Isotonic crystalloids are used in the treatment of Septic Shock?

Updated: Oct 07, 2020
  • Author: Andre Kalil, MD, MPH; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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Answer

Isotonic crystalloids

Isotonic sodium chloride solution (normal saline [NS]) and lactated Ringer (LR) solution are isotonic crystalloid fluids, the standard intravenous (IV) fluids used for initial volume resuscitation. Another crystalloid solution used is Plasmalyte. These solutions expand the intravascular and interstitial fluid spaces. Typically, about 30% of administered isotonic fluid stays in the intravascular space; therefore, large quantities may be required to maintain adequate circulating volume.

NS and LR solution are isotonic and have equivalent volume-restoring properties. Although some differences exist in the metabolic changes observed with the administration of large quantities of the 2 fluids, for practical purposes and in most situations, the differences are clinically irrelevant. No demonstrable difference in hemodynamic effect, morbidity, or mortality exists between resuscitation with NS and resuscitation with LR solution.

Normal saline (NS, 0.9% NaCl)

Normal saline restores interstitial and intravascular volume. It is used in initial volume resuscitation.

Lactated Ringer

LR solution restores interstitial and intravascular volume. It is used in initial volume resuscitation.

Plasmalyte

Normal saline restores interstitial and intravascular volume. It is used in initial volume resuscitation.


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