What are the principles of intravenous infusion sequence?
Aug 22, 2023
Source: Cainiu Health
Dr. Yang Shuwen
Introduction
In general, the principles for intravenous infusion sequence are: starting fast and then slowing down, administering saline before glucose, crystalloids before colloids, concentrated solutions before dilute ones, and supplementing potassium only after urine output is observed. Intravenous infusion is an important clinical method used to resuscitate critically ill patients and maintain internal environmental stability and acid-base metabolic balance. It is a highly precise medical procedure; therefore, patients requiring infusion therapy should always seek treatment at正规 hospitals.
Under normal circumstances, the principles for intravenous (IV) infusion sequence are: starting fast and then slowing down, administering saline before glucose, crystalloids before colloids, concentrated solutions before dilute ones, and supplementing potassium only after urine output is observed. IV infusion is a critical clinical method used to resuscitate critically ill patients, maintain internal environmental stability, and balance acid-base metabolism. The details are as follows:
1. Start fast, then slow down
During the first half to one hour in cases of patient shock, the infused volume should reach at least half of the patient's fluid loss. For example, if a patient has lost 1000 mL of blood, rapid fluid replacement is required—infusing at least 500 mL within the first 30 to 60 minutes—after which the infusion rate should be gradually reduced.
2. Saline before glucose
Administering saline before glucose helps promptly replenish missing electrolytes and restore the patient’s fluid balance.
3. Crystalloids before colloids
Crystalloids refer to common IV fluids such as normal saline, while colloids include natural or synthetic substances like plasma protein or albumin. Administering crystalloids first helps rapidly expand blood volume. Additionally, during fluid replacement, the composition of lost fluids should guide the proportional selection of replacement solutions.
4. Concentrated before dilute
"Concentrated" and "dilute" refer to the osmotic pressure (tonicity) of the solution. For correcting dehydration, a half-strength (½ osmotic) solution is typically used, whereas a fifth-strength (⅕ osmotic) solution is used for maintenance.
5. Supplement potassium only after urine output is observed
Abnormal serum potassium levels—either too high or too low—can lead to severe complications. Potassium follows the rule: "the more intake, the more excretion; less intake, less excretion; no intake, no excretion." Since the primary route of potassium excretion is through urine, potassium should only be supplemented once adequate urine output is confirmed. Additionally, the concentration of potassium in the infusion should not exceed 0.3%.
IV infusion is a highly precise medical procedure. Patients requiring IV therapy should always seek treatment at正规 medical facilities and avoid self-administration at home or receiving infusions at unlicensed clinics without proper medical qualifications.
