PAEA Surgery End Of Rotation (EOR) Practice Exam

Which type of fluid should be avoided in patients with brain injuries due to the risk of worsening brain edema?

1. Normal saline

2. Ringer's lactate

3. Dextrose solutions

4. Colloids

The correct answer is: Dextrose solutions

In patients with brain injuries, the use of dextrose solutions should be avoided due to the potential for worsening brain edema. Dextrose solutions can lead to hyperglycemia, which has been associated with increased cerebral edema and is thought to aggravate secondary injury mechanisms in the brain. When glucose levels rise, it can influence osmotic gradients and contribute to fluid shifts that exacerbate swelling in the injured brain tissue. Normal saline and Ringer's lactate solutions are typically more isotonic and are less likely to promote edema compared to dextrose solutions. These fluids provide necessary hydration and electrolytes without introducing glucose, and they help maintain an appropriate osmotic balance. Colloids are effective for volume expansion but are not inherently related to the metabolism of glucose or the resultant effects on cerebral edema. Thus, in managing patients with brain injuries, care is taken to avoid solutions that can increase glucose levels and potentially worsen the patient's condition.