According to the research, "of the 256 hospitals responding" to the survey, 88% of hospitals use Lactated Ringers to dilute oxytocin. 14% use D5W, 11% used 0.9% NaCl, and the remaining 9% use 0.45% NaCl. The reason for the % inconsistencies were because several institutions state that they use more than 1 type of fluid to dilute oxytocin.
Protocol for this dilution is included in the policies and procedures of each institution and "nurses play a strategic role in the development and implementation of hospital protocols for patient care".
According to ACOG, the suggested guidelines indicate that "oxytocin is usually diluted 10 units in 1,000 ml of an isotonic electrolyte solution". It is important to note that oxytocin has an antidiuretic effect. This can put the "women at increased risk for dilutional hyponatremia". A percentage of sodium is present in all solutions noted except D5W and 0.45% NaCl is a hypotonic solution whereas the others are isotonic. So according to ACOG, both D5W and 0.45% NaCl fall outside of the guidelines. |
