From the Guidelines
D5 half normal saline is not the preferred choice for intravenous rehydration, as the latest expert consensus recommends using water with dextrose or glucose, such as 5% dextrose, for patients who require intravenous fluids 1.
Key Considerations
- D5 half normal saline contains 5% dextrose and 0.45% sodium chloride, providing both free water and some electrolytes.
- However, the use of salt-containing solutions, including D5 half normal saline, should be avoided in patients with conditions like nephrogenic diabetes insipidus, as they can exacerbate hypernatremia 1.
- The recommended approach for intravenous rehydration is to use water with dextrose or glucose, calculating the initial rate of fluid administration based on physiological demand, with routine maintenance rates varying by patient weight and clinical condition 1.
Clinical Applications
- D5 half normal saline may still be used in certain clinical contexts, such as maintenance fluids for patients at risk for hypoglycemia or with mild hyponatremia, but its use should be cautious and tailored to individual patient needs.
- In general, the choice of intravenous fluid should prioritize the use of water with dextrose or glucose, as recommended by the latest expert consensus, to minimize the risk of complications and optimize patient outcomes 1.
From the Research
D5 Half Normal Saline
- D5 half normal saline is a solution that contains 5% dextrose and half the normal concentration of saline (0.45% sodium chloride) 2, 3, 4.
- The use of D5 half normal saline for rehydration has been studied in various clinical settings, including the treatment of dehydration in elderly patients 2 and hyperemesis gravidarum 4.
- Research suggests that D5 half normal saline can be used effectively for rehydration, with similar rates of adverse effects to intravenous infusion 2.
- A study comparing D5 half normal saline with normal saline for rehydration of hyperemesis gravidarum found no significant difference in primary outcomes, but a significant difference in favor of D5 half normal saline for nausea visual numerical rating scale score at 8 and 16 hours 4.
- Another study found that maintenance intravenous therapies using normal saline, dextrose-supplemented saline, or lactated Ringer solution have different effects on metabolic balance, and a personalized fluid therapy that takes into account the clinical and biochemical variables is advised 3.
- The safety and effectiveness of subcutaneous infusion of D5 half normal saline for rehydration of elderly patients have been assessed, and the evidence suggests that it can be used effectively, with similar rates of adverse effects to intravenous infusion 2.