What is the fluid of choice for rapid correction of hypotension?

What is the fluid of choice for rapid correction of hypotension?

• A. Lactated Ringer's
• B. 0.9% Sodium Chloride
• C. Dextrose 5% in water
• D. 0.45% Sodium Chloride

Answer: (B)

Restoring blood pressure quickly hinges on expanding the intravascular fluid volume with an isotonic crystalloid. Normal saline fits this role best because it has a similar osmolality to plasma and stays mainly in the extracellular space, rapidly boosting circulating volume when given as a rapid IV bolus. This directly increases preload and cardiac output, helping to raise blood pressure promptly. Dextrose-containing fluids, once the glucose is metabolized, become free water and do not reliably increase intravascular volume, so they’re not ideal for immediate correction of hypotension. A hypotonic solution would draw water into cells rather than expand the circulating volume, which can worsen hypotension. Lactated Ringer’s is also isotonic and can be used for fluid resuscitation, but for rapid correction of hypotension, normal saline is the standard initial choice because it provides ongoing plasma volume expansion without the metabolic considerations associated with lactate or the potential compatibility issues with certain therapies.

Restoring blood pressure quickly hinges on expanding the intravascular fluid volume with an isotonic crystalloid. Normal saline fits this role best because it has a similar osmolality to plasma and stays mainly in the extracellular space, rapidly boosting circulating volume when given as a rapid IV bolus. This directly increases preload and cardiac output, helping to raise blood pressure promptly.

Dextrose-containing fluids, once the glucose is metabolized, become free water and do not reliably increase intravascular volume, so they’re not ideal for immediate correction of hypotension. A hypotonic solution would draw water into cells rather than expand the circulating volume, which can worsen hypotension. Lactated Ringer’s is also isotonic and can be used for fluid resuscitation, but for rapid correction of hypotension, normal saline is the standard initial choice because it provides ongoing plasma volume expansion without the metabolic considerations associated with lactate or the potential compatibility issues with certain therapies.