Question: relative efficacy of PO versus parenteral fluid volume resuscitation.

[mycrofft]

I know there are some absolute advantages and absolute risks to intravenous fluid volume replacement; in the hands of a trained and thoughtful prctitioner, the former far outweigh the latter, given the proper equipment and accessible veins. I also know that oral fluids are cheap, often readily available, nearly anyone with a brain can use them, and carry their own sets of anticipatable risks and benefits.

My question is, off the top of your head, do you know the relative efficacy of a liter of IV fluid (say, NS) versus a liter of oral fluids (say, 1/2 strength Gatoraid, or Pedialyte, at 70 deg F), as far as volume-absorbed and time to absorption?

 

[18G]

I know there are some absolute advantages and absolute risks to intravenous fluid volume replacement; in the hands of a trained and thoughtful prctitioner, the former far outweigh the latter, given the proper equipment and accessible veins. I also know that oral fluids are cheap, often readily available, nearly anyone with a brain can use them, and carry their own sets of anticipatable risks and benefits.

My question is, off the top of your head, do you know the relative efficacy of a liter of IV fluid (say, NS) versus a liter of oral fluids (say, 1/2 strength Gatoraid, or Pedialyte, at 70 deg F), as far as volume-absorbed and time to absorption?

Don't know of any studies off the top of my head but know from doing rehab stuff that the osmolarity (thickness of the fluid) and temp of the fluid does have affect on absorption rate.

 

[8jimi8]

1/3rd of 0.9% NS infused remains in the intravascular space 1 hour after administration.


It sounds like a rather complex study to figure out the amount of fluid retained after PO intake.

 

[jwk]

Fluid is absorbed through the bowel. Significant trauma essentially brings gastric emptying to a screeching halt. So all you'd be doing is filling up the stomach with fluid and letting it sit there.

 

[mycrofft]

Not only does it stop emptying, but the Boomerang Effect takes over.

On the other hand, if the pt is uninjured and potentially dehydrated...but still, vomiting and airway isisues can apply if trauma happens before gastric emptying. (And water goes through stomach faster than food, it's sort of fascinating).