Core pharmacology

Class Group

Crystalloid

Legacy Cicm Level

Level 1

Introduction

Compound sodium lactate

Indications Uses

1. in the treatment of dehydration
2. for the acute expansion of intravascular volume and
3. to provide maintenance fluid and electrolyte requirements
in the perioperative period.

Presentation

As a clear, colourless sterile solution in 500/1000 ml bags

Physiological effects

CVS The haemodynamic effects of Hartmann’s solution are proportional to
the prevailing circulating volume and are short-lived.

GU Renal perfusion is temporarily restored towards normal in hypovolaemic patients transfused with the crystalloid.

Metabolic/other 1 l of one-sixth molar sodium lactate is potentially equivalent to 290 ml of 5% sodium bicarbonate in its acid-neutralizing effect and
to 600 ml of 5% glucose in its antiketogenic effect

Adverse Effects Toxicity

The predominant hazard is that of overtransfusion, leading to hypernatraemia, pulmonary oedema, and metabolic
alkalosis.

Absorption

IV. BA 100%

Distribution

initially distributed into the plasma but
later equilibrates with the extracellular fluid.

Metabolism

- The lactate component is oxidized in the liver to bicarbonate
and glycogen over a period of about 2 hours.
- This is dependent on cellular
oxidative activity, and the mechanism may be depressed by hypoxia and
liver dysfunction.

Excretion

Excretion Via the urine.

Special Points

pH 6.5 (6-7.3)
Osm 278

Na 131
Cl 111
K 5
Ca 2
Lactate 29