Which fluid is typically used as a volume expander in neonatal resuscitation?

Normal saline (0.9% NaCl) is commonly used as a volume expander in neonatal resuscitation primarily due to its ability to quickly restore intravascular volume in newborns experiencing conditions such as hypovolemia or shock. This isotonic solution effectively increases circulating blood volume without causing significant shifts in fluid between compartments, making it suitable for initial resuscitation efforts.

The choice of normal saline is also influenced by its compatibility with the body's existing electrolytes, thus minimizing the risk of complications that could arise from the introduction of other solutions. It contains sodium and chloride in concentrations that are beneficial for maintaining electrolyte balance during the critical period of resuscitation.

While other solutions such as 5% dextrose in water are used for different purposes, they do not serve as effective volume expanders since they do not provide sufficient sodium to restore or maintain blood volume. Lactated Ringer's solution and Plasma-Lyte A may also be used for fluid resuscitation but are typically considered when there is a specific need for electrolyte replacement or when the clinical scenario dictates their use. Thus, for straightforward volume expansion during neonatal resuscitation, normal saline remains the standard choice.