A balanced, multi-electrolyte intravenous solution designed for the correction of extracellular fluid volume and electrolyte deficits, particularly in metabolic acidosis. It is a modification of Ringer's Lactate (Hartmann's solution) with a specific, fixed electrolyte composition. Sodium Lactate serves as a bicarbonate precursor, metabolized in the liver to bicarbonate, aiding in the correction of acidosis. It is a first-line choice for fluid resuscitation in hypovolemic shock, surgical fluid replacement, and management of acute diarrheal dehydration in the Indian clinical setting.
Adult: Dose is individualized based on patient's weight, clinical condition, and fluid/electrolyte deficits. General guidelines: For resuscitation: 1-2 liters rapidly (e.g., 20 mL/kg). For maintenance: 1.5-3.0 L/day (approx. 30-40 mL/kg/day). Rate: Typically 500 mL to 1000 mL over 1-8 hours.
Note: For intravenous use only. Must be administered using sterile technique. Use a clean, non-pyrogenic infusion set. Check for clarity and seal integrity before use. Do not administer if particulate matter or discoloration is present. Can be given via peripheral or central line. Do not add supplementary electrolytes or other medications unless compatibility is confirmed. Incompatible with amphotericin B, fat emulsions, and certain antibiotics like ceftriaxone (risk of calcium-ceftriaxone precipitation).
This polyionic solution works by restoring intravascular volume, correcting electrolyte imbalances, and providing a substrate (lactate) for endogenous bicarbonate generation. Sodium and Chloride are the principal extracellular ions, restoring osmolality and volume. Potassium is the major intracellular cation, crucial for membrane potential. Calcium is essential for neuromuscular function, cardiac contractility, and coagulation. Lactate anion is converted in the liver to bicarbonate, effectively raising blood pH and correcting metabolic acidosis.
Pregnancy: Category C (US FDA). No well-controlled studies. Should be used only if clearly needed, as electrolyte and fluid balance is crucial. Generally considered safe for short-term use in standard doses for indicated conditions.
Driving: No effect. The solution is administered in a clinical setting.
| Potassium-Sparing Diuretics (Spironolactone, Amiloride) | Increased risk of severe hyperkalemia. | Major |
| ACE Inhibitors (Ramipril, Enalapril) / ARBs (Losartan) | Increased risk of hyperkalemia. | Major |
| Cardiac Glycosides (Digoxin) | Hypercalcemia potentiates digoxin toxicity (increased risk of arrhythmias). Hypokalemia increases digoxin sensitivity. | Major |
| Corticosteroids (Prednisolone, Hydrocortisone) | Enhanced sodium and fluid retention, increasing risk of edema and hypertension. | Moderate |
| Ceftriaxone (IV) | Risk of fatal precipitation of calcium-ceftriaxone salts in the lungs and kidneys, especially in neonates. Do not administer simultaneously via same IV line. | Contraindicated |
Same composition (Sodium Chloride (0.600gm) + Sodium Lactate (0.32gm) + Potassium Chloride (0.040gm) + Calcium Chloride (0.027gm)), different brands: