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Hartmann's solution

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Hartmann's solution or compound sodium lactate is a crystalloid solution that is most closely isotonic with blood and intended for intravenous administration. Hartmann's IV Infusion is used to replace body fluid and mineral salts that may be lost for a variety of medical reasons. Hartmann's IV Infusion is especially suitable when the losses result in too much acid being present in the blood. Hartmann's solution is abbreviated as "CSL". It is very similar—though not identical to—lactated Ringer's solution, the ionic concentrations of which differ.

Overview

One litre of Hartmann's solution contains:

This amounts to an osmolarity of 279 mOsm/L.[1]

Generally, the sodium, chloride, potassium and lactate come from NaCl (sodium chloride), NaC3H5O3 (sodium lactate), CaCl2 (calcium chloride), and KCl (potassium chloride).

Hartmann's IV infusion is given via an intravenous line (drip) and can be administered at various rates depending on the cause for necessity.

Contraindications

Hartmann's solution may be relatively contraindicated in patients with diabetes mellitus, as one of the isomers of lactate is gluconeogenic.[2] Hartmann solution should not be given if the patient has congestive heart failure (constant wheezing, shortness of breath), ischaemic stroke (have had a stroke), liver disease as a consequence of alcoholism, or severe reduction in kidney function.

Side effects

Some swelling of the hands, ankles and feet may be experienced due to fluid retention in the body. In rare circumstances, this may also involve the lungs, which may cause some breathing difficulty. Other symptoms may include nausea, vomiting, headache, dizziness, drowsiness or confusion. Inflammation at the site of injection, or swelling of the veins near the site of injection is also possible.

References

  1. ^ http://www.frca.co.uk/article.aspx?articleid=291
  2. ^ D. J. B. Thomas AND K. G. M. M. Alberti, 'Hyperglycaemic effects of Hartmann's solution during surgery in patients with maturity onset diabetes', British Journal of Anaesthesia, (1978, 50, 185) - http://bja.oxfordjournals.org/cgi/content/abstract/50/2/185