Compound sodium lactate

Also known as

• Hartmann’s solution
• Ringer's lactate solution

 

Common indications

• To provide sodium and water intravenously in patients unable to take enough orally.
• To expand circulating volume in states of circulatory compromise (including shock).

 

Mechanisms of action

• Its constituents are designed to mimic serum, at least in terms of electrolytes. 
• One litre contains Na⁺ 131 mmol, Cl⁻ 111 mmol, K⁺ 5 mmol, Ca²⁺ 2 mmol, and lactate 29 mmol. 
• In the presence of adequate liver function, the lactate is metabolised to pyruvate and then either to glucose or carbon dioxide and water, with the release of bicarbonate in both cases.

 

Important adverse effects

• Excessive administration of compound sodium lactate can cause a fall in cardiac output and severe heart failure by increasing left ventricular filling beyond the point of maximal contractility on the Starling curve.
• Oedema may be caused by providing sodium more rapidly than the patient can excrete it.

 

Warnings

• To be added