Hartmann's solution

Hartmann's solution or compound sodium lactate (CSL) 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. It is especially suitable when the losses result in too much acid being present in the blood and is very similar—though not identical—to lactated Ringer's solution, the ionic concentrations of which differ.

It is named after US paediatrician A. F. Hartmann (1898–1964).

Overview

One litre of Hartmann's solution contains:

• 131 mEq of sodium ion = 131 mmol/L.
• 111 mEq of chloride ion = 111 mmol/L.
• 29 mEq of lactate = 29 mmol/L.
• 5 mEq of potassium ion = 5 mmol/L.
• 4 mEq of calcium ion = 2 mmol/L .

This amounts to an osmolarity of 279 mOsm/L.

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 and urgency.

Contraindications

Hartmann's solution may be relatively contraindicated in patients with diabetes mellitus, as one of the isomers of lactate is gluconeogenic.

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.