Which IV solution should be used with blood products?

Which IV solution should be used with blood products?

• A. Dextrose-containing solution
• B. Lactated Ringer's solution
• C. Normal saline 0.9%
• D. 0.45% saline

Answer: (C)

The key idea is to use an IV fluid that is isotonic with blood and won’t interact with the blood product’s anticoagulant. Normal saline 0.9% fits this because it matches plasma osmolality and contains no calcium or glucose that could alter the transfused product. Using this fluid helps keep the red blood cells intact during transfusion and preserves the citrate anticoagulant in the blood product. Dextrose-containing solutions should be avoided because once the glucose is metabolized, the fluid becomes hypotonic, which can cause red blood cells to hemolyze. Lactated Ringer’s contains calcium, which can counteract the citrate anticoagulant in the blood product and promote clotting. A solution with 0.45% saline is hypotonic and would also risk hemolysis.

The key idea is to use an IV fluid that is isotonic with blood and won’t interact with the blood product’s anticoagulant. Normal saline 0.9% fits this because it matches plasma osmolality and contains no calcium or glucose that could alter the transfused product. Using this fluid helps keep the red blood cells intact during transfusion and preserves the citrate anticoagulant in the blood product.

Dextrose-containing solutions should be avoided because once the glucose is metabolized, the fluid becomes hypotonic, which can cause red blood cells to hemolyze. Lactated Ringer’s contains calcium, which can counteract the citrate anticoagulant in the blood product and promote clotting. A solution with 0.45% saline is hypotonic and would also risk hemolysis.