I enjoyed the lecture. As expected, this lecture is very useful and good. I have a question. The fluid types of bag1 and bag2 shown as examples in the lecture are both 0.9%NS. I am wondering if it is possible to use a fluid such as Hartmann's solution or Plasma Solution A instead of 0.9%NS.
Dear @moa_4777, thank you for your question and kind words. Since insulin (Bag 1) is compatible with salts of calcium, it should be fine to mix it with other replacement solutions, such as those mentioned. However, the data on the stability of insulin in these solutions is minimal, and the majority of literature recommends mixing insulin in NS 0.9%. If you add potassium phosphate to Bag 2, ideally, you don’t want to mix it with salts of calcium or magnesium due to the risk of physical incompatibility. Therefore, using NS 0.9% would be the safest choice. If KCl is the only solution mixed with the replacement fluid in Bag 2, Hartmann’s and Plasmalyte A can be used. That said, there is a lack of studies proving that K-Phos cannot be mixed with Hartmann’s/LRS/Plasmalyte. Until these studies are available, I normally recommend using NS 0.9% if K-Phos is used.
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Amazing! You made those complex calculations so easy. Thanks Doctor Igor.
You're welcome, my friend!
I enjoyed the lecture.
As expected, this lecture is very useful and good. I have a question.
The fluid types of bag1 and bag2 shown as examples in the lecture are both 0.9%NS.
I am wondering if it is possible to use a fluid such as Hartmann's solution or Plasma Solution A instead of 0.9%NS.
Dear @moa_4777, thank you for your question and kind words. Since insulin (Bag 1) is compatible with salts of calcium, it should be fine to mix it with other replacement solutions, such as those mentioned. However, the data on the stability of insulin in these solutions is minimal, and the majority of literature recommends mixing insulin in NS 0.9%.
If you add potassium phosphate to Bag 2, ideally, you don’t want to mix it with salts of calcium or magnesium due to the risk of physical incompatibility. Therefore, using NS 0.9% would be the safest choice.
If KCl is the only solution mixed with the replacement fluid in Bag 2, Hartmann’s and Plasmalyte A can be used. That said, there is a lack of studies proving that K-Phos cannot be mixed with Hartmann’s/LRS/Plasmalyte. Until these studies are available, I normally recommend using NS 0.9% if K-Phos is used.