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For people doing saline IVs: have slower drips been more effective?


lamp_girl
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I've done a few saline infusions over the course of ~1 hr, and they have been somewhat helpful-- I'm wondering if doing them slower would be better. I don't have a bad reaction to getting all that fluid in over just an hour, but am wondering if doing it over a longer period of time would make me feel ebtter.

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I also don't have a reaction to getting fluids over an hour but do benefit from slowing it down. We went from 1 Hr to 4.5 hrs and was obvious I could hold onto the fluid better, and so had an even better response. I was having so much trouble that my homecare nurse thought giving 24/7 a try and that has worked even better. Obviously not everyone can tolerate carrying around fluids 24/7 but I already have continuous tube feeds so already kind of used to it. The biggest diffrence is that it helps my blood pressure stabilize somewhat and I don't pass out as much.

Something also to keep in mind is that if your albumin is low that can affect your ability to retain/absorb fluid in the cells. Anytime my albumin is low I get almost no benefit from fluids, happened while I was in ICU a couple weeks ago and they couldn't figure out why I wasn't responding to the 3-4 liters of fluids. After they replaced my albumin finally made some headway. 

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I definitely see a BIG difference from getting slower IV fluids. I have received IV boluses ( 1 l as fast as it will go in ) before b/c the docs felt the fluids help b/c they thought I must be dehydrated. But over the years - and after many ER visits and hospitalizations - it has become clear that my BP and HR ( as well as orthostatic intolerance ) improve considerably by getting LR ( vs NSS ) at 125 - 150 ml/hr. Anything faster is useless. I believe this is because the slower rate and longer administration time improves intra-vascular pressure and therefore stops the ANS from dumping out adrenaline which constricts blood vessels. This theory is the only one that would explain why - proven in my medical record - my symptoms/HR/BP improve. Faster infusions give shorter results - longer ( and slower infusions ) give longer lasting results. It may not be the same for others ( since many people DO need the fluids to stop POTS from dehydration or hypovolemia ) but in my case this is the only theory I can approve of in my own personal case.  --- Also: when I get infusions of NSS ( normal saline ) I tend to swell up like the Pillsbury dough-boy. L R infusions do not have that effect on me plus they seem to have longer-lasting effects. 

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I haven't tried LR but I suspect it would be helpful compared to NSS. I am grateful to have any IV orders at all, so I don't want to rock the boat. I don't get edema from NSS, though.

 

I definitely find that slower infusions are more helpful. When I've had a time crunch or been very hypotensive, we've run the first liter in wide open, and I never seem to get as much benefit. I usually run 1500mL over 5-6 hours - I bet slower than that would be even better, but I don't have a pump so can't run it while sleeping, or in the car. If it were safe and doable for me, I sometimes fantasize about a slow, continuous drip on a pump-I just know I could do everything I used to do without much trouble, and I'd feel so much better.

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