This is used to treat hypovolemia caused by surgery, hemorrhage and trauma. Excessive sweating, severe diarrhoea or vomiting, excess loss of fluid by nephritic kidneys, inadequate intake of fluid and electrolytes etc. that may lead to typical hypovolemic shock may be corrected with this solution . Severe plasma loss caused by intestinal obstruction, burns or other denuding conditions of the skin may be treated with this solution. It is mainly used as a fluid and electrolyte replenisher. It may be used as an alternative to Sodium Bicarbonate in the treatment of metabolic acidosis associated with dehydration and to alkalinized urine.
A Multiple electrolyte intravenous solution is intended for restoring the electrolyte balance and water for hydration. A combination of multiple electrolyte and sodium lactate, alkalinising agent, will provide electrolyte balance and normalise the pH of the acid-base balance of the physiological system.
Sodium is the major cation of extracellular fluid and functions principally in the control of water distribution, fluid and electrolyte balance and osmotic pressure of body fluids. Chloride, the major extracellular anion, closely follows the physiological disposition of sodium cation in maintenance of acid-base balance, isotonicity and electrodynamic characteristic of the cells.
In contrast to sodium ion, potassium is a major cation of the intracellular fluid (160 mEq/liter of intracellular water) and functions principally in the control of body fluid composition and electrolyte balance. Potassium participates in carbohydrate utilisation, protein synthesis, and is critical in the regulation of nerve conduction and muscle contraction, particularly in the heart.
Calcium is essential for maintenance of the functional integrity of nervous, muscular, and skeletal system and cell membrane and capillary permeability. Calcium is the major component of the body skeleton. The calcium content in bone is continuously undergoing a process of resorption and formation. The normal concentration of calcium in plasma is between 2.2 to 2.6 mmol per litre.
Sodium lactate is an alkalising agent. Lactate is slowly metabolised to bicarbonate and water. This reaction depends on the cellular oxidative activity. Under normal physiological condition conversion of sodium lactate to bicarbonate requires about 1-2 hours. The bicarbonate metabolite is then has a similar actions to those of sodium bicarbonate preparations. That is, bicarbonate metabolites react with acid to produce carbon dioxide and water.
Dosage & Administration
The volume and rate of infusion will depend upon the requirements of the patients and the judgement of the physician. It usually varies with age, weight and clinical condition of the patient. The recommended flow rate is up to 100-drops/minute/70 kg body weight. In burn patients the dose of Hartmann's solution according to the Parkland formula: 4 ml/kg body weight% of Body surface area (BSA) burn (e.g. for a 30% BSA burn of a person having 60 kg body weight, 4 x 60 x 30 ml = 7200 ml of Hartmann's solution would be required in 24 hours). Half of this within 8 hr, the remainder over 16 hr. Administration Procedure:
- Check infusion set and infusion solution prior to use
- Pull moderately to tear off the protective cover of the Eurohead
- Hold lightly the Eurohead but not the bag
- Open the flow regulator fully and hold the giving set on the top white area, but not the membrane venting region
- Insert the spike of the administration set to the Eurohead and fit the connector of the administration set firmly to the needle
- Gradually allow the fluid to flow down to the needle tip and close
- Remove the protective cover of the needle
- Locate the veinpuncture site and clean the site with an antiseptic solution, and then insert the needle
- Securely tape the puncture site
- Securely tape the wings and tubing
- Start infusion while adjusting drip speed
Do not use in patients with established renal failure.
Tissue edema can develop when large volumes are used.
Pregnancy & Lactation
Pregnancy Category C.
Precautions & Warnings
Hartmann's solution should not be administered rapidly or for prolonged periods. Since the solution contains different electrolytes, it should be infused with caution in patients where electrolyte imbalance may cause detrimental effects; e.g. in pregnancy, renal impairment, heart failure, pulmonary congestion, etc. or to patients receiving potassium sparing diuretics. In Pregnancy: Pregnancy Category C. Infusion of fluid should be immediately discontinued if rigor arises for any reason during the process. Do not use if the solution is cloudy, contains particles, or after expiry date.
Electrosal should be stored at controlled room temperature.
- Type IV
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