1. Plasma volume expander
2. Also expands interstitial fluid volume
3. Plasma volume effect is only temporary as most of the saline moves out of the blood vessels quite quickly

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

IV. BA 100%

IV. BA 100%

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

~15mins:
ISF 750mls
Plasma volume 250mls.
Not distributed to ICF

- 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.

Unmetabolized

Excretion Via the urine.

Excreted by kidney
Slower than balanced solutions

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

1. Fluid overload
2. hyperchloremic metabolic acidosis
3. increased risk of renal failure compared to balanced solutions
4. Injury to endothelial glycocalyx

Crystalloid

Crystalloid

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.

1. Initial replacement fluid, in volume depleted or dehydrated patients. Volume depletion may be due to loss of blood, plasma or fluid and electrolytes.
2. Maintenance of hydration during prolonged patient contact time.
3. To keep vein open, as IV route for drugs.

Compound sodium lactate

intravenous fluid with 9g NaCl in litre of sterile water.
Isotonic crystalloid solution

Level 1

Level 1

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

500 or 1000mls of 0.9% Sodium Chloride solution in a collapsible plastic flask or bag.

pH 6.5 (6-7.3)
Osm 278

Na 131
Cl 111
K 5
Ca 2
Lactate 29

pH 5.0
Osm 308
Tonicity 286

Na 154
Cl 154