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 (J.
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, e.g.
"We have found that
hypotonic solutions (low in salt) strongly activate inflammation at molecular level.
Hypotonic solutions 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.