What is sodium lactate injection?
1 Basic concept of drugs Sodium lactate injection is a drug that regulates water, electrolytes, and acid-base balance. It is a transparent and clear liquid packaged in ampoules. It is usually a sterile injection solution, with a concentration calculated based on the molar amount per liter. Common specifications include 11.2% solution and appropriately diluted concentration.
The core ingredient of the drug is sodium lactate, with a molecular formula of C3H5NaO3, which contains sodium ions and lactate ions. After entering the bloodstream, lactate ions are converted into bicarbonate ions (HCO3 ⁻) by the liver, neutralizing excess hydrogen ions, thereby regulating blood pH and improving the acidic environment in the body. Sodium lactate solution can participate in biochemical reactions and has compatibility contraindications with other drugs such as calcium supplements.
3 Indications and scope of application
3.1 Correction of metabolic acidosis plays an auxiliary role in regulating acidosis caused by diabetes, lactic acid accumulation due to shock or renal failure. Compared to sodium bicarbonate injection, sodium lactate is suitable for patients with normal liver function because its conversion process depends on liver metabolic function.
3.2 Treatment of hyperkalemia: Sodium lactate containing sodium ions promotes blood alkalization, facilitates the transfer of potassium from extracellular fluid to cells, and reduces blood potassium concentration in the short term. It is commonly used in emergency rescue combined with hemodialysis treatment.
3.3 Application of Assistive Surgery: During cardiopulmonary surgery, metabolic disorders may lead to a tendency towards acidosis. The medical team slowly regulates the acid-base levels of the circulatory system through infusion to maintain vital signs.
4 Pharmacological Mechanisms of Action: After intravenous infusion, sodium lactate is broken down into water and carbon dioxide by enzymes in the liver, producing HCO3 ⁻, which directly neutralizes acidic substances in the blood and increases pH. At the same time, sodium ions replenish electrolytes in the body and balance intercellular fluid osmotic pressure.
The usage method and preparation principle must be intravenous injection or mixed with other fluids for drip infusion. In emergency situations, dilute an appropriate amount of 10% glucose injection or physiological saline to a 1/6 molar concentration (approximately 1.87%), and determine the specific dosage according to the formula and actual physical signs. The single dose for adults is usually calculated starting from 0.3mol/kg and adjusted according to blood gas analysis. Excessive administration should not cause severe alkalosis.
Possible adverse reactions include nausea, vomiting, increased heart rate, or dizziness caused by rapid infusion speed. Insufficient dilution of the drug solution can stimulate veins and cause tissue necrosis. Patients at risk of sodium retention need to monitor their blood pressure for long-term use. Although there are few cases of allergies, it is important to be alert to redness, itching, and difficulty breathing.
7. Medication contraindications and population classification: Prohibited for individuals sensitive to sodium lactate. Patients with liver dysfunction and severe pulmonary edema are prohibited from using it. Patients with congestive heart failure and a decrease of more than 30% in glomerular filtration rate should be carefully evaluated to prevent sodium and water retention and focus on renal burden.
8 Precautions for Medical Environment: Medication should be administered under the guidance of a doctor. Real time tracking of potassium concentration, pH, and PCO ₂ values in the patient's blood. For burn patients and trauma shock patients, corrective treatment should be carried out after improving circulation. Pediatric use should be accurately calculated based on body weight to avoid overdose.
Storage and packaging requirements: Store in an environment away from light and at a temperature not exceeding 25 ℃ to avoid freezing and deformation that may cause ampoule breakage. After opening, it cannot be retained and needs to be used up in one go. Most of the products sold on the market are packaged in glass ampoules, with different specifications ranging from 20ml to 100ml per bottle. When sediment or foreign matter is found, it should be immediately discarded.
Exploration of 10 Special Use Scenarios: An Emergency Treatment Scenario for Hyperkalemia Accompanied by QRS Wave Widening. The Combination of Sodium Lactate, Calcium Gluconate, and Insulin can Quickly Reduce Blood Potassium, Seizing the Opportunity for Subsequent Dialysis. However, if chronic acidosis is caused by liver function damage and the effect of sodium lactate is reduced, the strategy of acid correction should be switched.