Which IV fluid is most likely contraindicated in a patient with traumatic brain injury and increased intracranial pressure?
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Correct answer: 0.45% NaCl (half normal saline)
Hypotonic fluids such as 0.45% NaCl shift water into brain cells, aggravating cerebral edema and raising intracranial pressure, so they are contraindicated in TBI with elevated ICP. Hypertonic (3%) saline is instead used to reduce ICP.
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