However, recent studies have demonstrated that the tonicity of the enteral rehydration solution affects the level of water and electrolyte absorption, with hypotonic solutions
resulting in better water absorption than isotonic solutions in children (RAUTANEN et al., 1993), laboratory animals (NISHINAKA et al., 2004), and horses (RIBEIRO FILHO et al., 2014).
The nursing care of patients with a fluid volume deficit diagnosis focuses on increasing fluid intake with 0.9% NS, LR or hypotonic solutions
, replacing electrolytes, restricting sodium in cases of hypernatremia, and offering oral free water (Daniels, 2010; Daniels & Nicoll, 2012).
The AAGL's Practice Guidelines for the Management of Hysteroscopic Distending Media lists an intravasation safety limit of 2,500 cc for isotonic solution, compared with a maximum limit of 1,000 cc when using hypotonic solutions
Product manager, Melanie Tymm, told OT: "Research has shown that hypotonic solutions
provide measurably greater improvements in the symptoms of dry eye syndrome than isotonic solutions so changing Hyabak to a hypotonic solution
was a natural progression for the company."
Fluids that should not be used in septic shock are 5% dextrose or hypotonic solutions
"We have found that hypotonic solutions
(low in salt) strongly activate inflammation at molecular level.
contain only minimal solute concentrations and greater concentrations of water.
The degrees of swelling and osmotic resistance in hypotonic solutions
of erythrocyte from various domestic animals.
Four pediatric deaths due to acute hyponatremia associated with intravenous (IV) administration of hypotonic solutions
, three in a postsurgical setting and the other in a medical setting were voluntarily reported (two to the Institute for Safe Medication Practices Canada [ISMP Canada] and two to the Institute for Safe Medication Practices [ISMP] in the United States).
Findings from a meta-analysis that included 6 randomized controlled trials indicated that hypotonic solutions
(less than 0.9% NS) significantly increased the risk of developing acute hyponatraemia over isotonic (0.9% NS or Ringers Lactate) solutions.
Because rapid fluid replacement with hypotonic solutions
carries an increased risk of cerebral edema, the consensus statement urged slower fluid-deficit correction with isotonic or near-isotonic solutions, which achieve earlier reversal of acidosis.
Maternal hydration with oral water or intravenous hypotonic solutions
has been shown to increase amniotic fluid volume.