About the ads

Why D5w Is Bad For Patients With Brain Injury?

Discussion in 'Pharmacy' started by konkan, Jan 12, 2008.

  1. SDN is a nonprofit organization. Services are made possible through the generous support of SDN members and sponsors. Thank you.
  1. konkan

    konkan coup de grace

    Joined:
    Sep 11, 2005
    Messages:
    300
    Status:
    Pharmacist
    SDN 7+ Year Member

    SDN Members don't see this ad. (About Ads)
    Can someone explain why D5W is bad for patients with brain injury? Pharmacist in my hospital told me that. I thought D5W is hypertonic because of the sugar, therefore it should be drawing fluids from the brain - supposedly a beneficial thing for patients with brain swelling.
  2. SpirivaSunrise

    SpirivaSunrise Go Gators! Lifetime Donor

    Joined:
    Apr 29, 2006
    Messages:
    4,309
    Location:
    Off the coast of somewhere beautiful
    Status:
    Pharmacist
    Pharmacist SDN Published Author SDN 7+ Year Member
    D5W is isotonic initially...then the sugar is metabolized, and it becomes hypotonic (just water)...which will flush out of the vasculature and into the cells...and worsen the cerebral edema.
  3. psychoandy

    psychoandy Junior Member

    Joined:
    Aug 30, 2005
    Messages:
    431
    SDN 7+ Year Member
    1.) Straight D5W is slightly hypoosmotic (something like ~270 milliosmoles), and if you remember a&p lectures, h2o goes from low to high concentration.
    With head traumas, your main goal is to decrease ICP; you want less fluid in your head, so you mix whatever drug in NS. Since it's isoosmotic/slightly hyperosmotic, the ICP should decrease since free water will be moving towards the body/circ system, as opposed to staying in your noggin. For an increased response, they can hang 3% NaCl, or in special ICU cases, a bolus of 23.4% NaCl.

    2.) On a less important note, tight glycemic control generally equals better outcome, and making everything in NS makes it easier for RNs to titrate the insulin drip...just make sure they're getting glucose via diet or something.

Share This Page


About the ads