Sodium lactate compound parenteral
- Drugs List
- Therapeutic Indications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
Intravenous infusion of sodium lactate compound
Coma - diabetic
Correction of fluid and electrolyte loss
Metabolic acidosis - mild to moderate
The rate and volume of infusion depends on the requirements of the individual patient and the judgement of the physician. Dosage should be based on the age, weight and clinical condition of the patient.
The amount of compound sodium lactate solution needed to restore normal blood volume is 3 to 5 times the volume of lost blood.
500ml to 3litres in 24 hours.
According to individual requirements.
Elderly patients should be treated with caution to avoid circulatory overload, especially those with cardiac or renal impairment.
20ml to 100ml/kg in 24 hours.
In children with burns, the dose is on average 3.4ml/kg/percent burn at 24 hours post-burn and 6.3ml/kg/percent burn at 48 hours.
In severely head-injured children the dose is on average 2850ml/square metre.
For intravenous infusion.
The infusion rate is usually 40ml/kg/24 hours in adults.
The average paediatric infusion rate is 5ml/kg/hour but the value varies with age:
Children aged 2 to 11 years: 2 to 4ml/kg/hour
Toddler: 4 to 6ml/kg/hour
Infant: 6 to 8ml/kg/hour
Infusion rate and total volume can be higher in surgery or in case of need.
Neonates under 1 month
Decompensated cardiac failure
Severe hepatic impairment
Severe renal impairment
Precautions and Warnings
Children aged 1 to 6 months
Not all available brands are licensed for all indications
Potassium deficient patients should receive potassium supplements
Avoid rapid infusion rates
Use only if the solution is clear and colourless
Monitor acid-base balance
Monitor blood glucose
Monitor ECG prior to and during treatment in existing cardiac abnormalities
Monitor fluid balance
Monitor patients with cardiac disorders
Monitor serum electrolytes
Discontinue if allergic reaction occurs
Discontinue if lactic acidosis is suspected
The manufacturer recommends that sodium lactate compound is contraindicated in severe metabolic acidosis. Some sources suggest that sodium lactate is no longer used in metabolic acidosis because of the risk of producing lactic acidosis, particularly in seriously ill patients with poor tissue perfusion or impaired hepatic function.
Pregnancy and Lactation
Sodium lactate compound infusion can be given during pregnancy but should be used with caution in toxaemia of pregnancy.
The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Sodium lactate compound infusion can be given during breastfeeding as its use is not considered to constitute a hazard.
Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1
Thrombophlebitis (injection site)
It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.
The following number will direct the caller to the relevant local centre (0844) 892 0111
Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Last Full Review Date: August 2013
Summary of Product Characteristics: Compound Sodium Lactate Intravenous Infusion BP (Hartmann's Solution). Baxter Healthcare Ltd. Revised February 2013.
Summary of Product Characteristics: Hartmann's Solution for Injection BP as Steriflex No.11 or freeflex. Fresenius Kabi Ltd. Revised January 2010.
NICE Evidence Services Available at: www.nice.org.uk Last accessed: 05 September 2017
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