The efficacy of Sodium Lactate Ringer Injection
Detailed explanation of the efficacy and clinical application of Sodium Lactate Ringer Injection ① Mechanism of action: A "versatile player" for fluid supplementation, electrolyte balance, and acid-base regulation. Sodium Lactate Ringer Injection is a compound crystal solution, and its core efficacy is achieved through three mechanisms: - Fluid supplementation: As an isotonic solution (osmotic pressure close to plasma, about 273mOsm/L), it can quickly expand blood volume and maintain effective circulating blood volume in blood vessels (similar to "replenishing water to dehydrated sponges", isotonic characteristics prevent water from penetrating into cells too quickly). -Electrolyte balance: Contains physiological ions such as sodium (Na ⁺), potassium (K ⁺), calcium (Ca ² ⁺), and chlorine (Cl ⁻), accurately matching the composition of human extracellular fluid (such as sodium ions maintaining plasma osmotic pressure, potassium ions participating in myocardial and nerve cell electrical activity, and calcium ions promoting muscle contraction). -Acid base regulation: Sodium lactate is metabolized into bicarbonate ions (HCO ∝⁻) in the liver, which can neutralize excess acidic substances in the body (such as lactate accumulation produced by anaerobic metabolism during shock) and correct metabolic acidosis (similar to the "acid-base buffering agent" in the body). ② Typical clinical application examples: From emergency rescue to daily treatment, the "practical performance" of sodium lactate Ringer is widely used in various clinical scenarios due to its high safety and strong adaptability. The following are specific examples: Example 1: "Rapid recovery" of traumatic hemorrhagic shock - Scene: In 2023, a 30-year-old male patient with pelvic fracture and hemorrhagic shock caused by a car accident was admitted to the emergency department of a tertiary hospital (blood pressure 65/40mmHg, heart rate 130 beats/min, urine volume<20ml/h). -Operation: Immediately open two peripheral venous pathways and administer the first dose of 1000ml of Sodium Lactate Ringer Injection rapidly (infusion rate 500ml/h), while monitoring blood pressure, heart rate, urine output, and blood gas analysis. -Result: After 30 minutes, blood pressure rose to 90/60mmHg, heart rate dropped to 110 beats per minute, and urine output returned to 30ml/h; Continue to infuse at a rate of 150ml/h, with a total fluid replacement volume of 3000ml over 24 hours. No hypernatremia or hypokalemia was observed (blood sodium maintained at 135-145mmol/L, blood potassium 3.5-5.5mmol/L).
Example 2: Dehydration correction for heatstroke and heat stroke - Scenario: In the summer of 2024, a 45 year old worker at a construction site developed heat stroke (body temperature 41 ℃, blurred consciousness, dry skin without sweat, blood sodium 150mmol/L, blood lactate 8mmol/L) due to high-temperature operation (ambient temperature 40 ℃, humidity 60%). -Operation: Immediately cool down (ice blanket+fan), while intravenous infusion of sodium lactate Ringer injection. Within the first hour, replenish 500ml of fluid (at a rate of 500ml/h), then adjust the speed according to "300ml of fluid for every 1 ℃ decrease in body temperature". Monitor blood sodium, blood lactate, and urine volume every 2 hours. -Result: After 6 hours, the body temperature dropped to 38 ℃, consciousness became clear, blood sodium decreased to 142mmol/L, blood lactate decreased to 3mmol/L, total fluid replacement volume was 1800ml, and no pulmonary edema occurred (no wet rales on lung auscultation, blood oxygen saturation maintained above 98%). Example 3: "Fluid Management" during the Perioperative Period of Abdominal Surgery - Scenario: A general surgery department in a hospital performed laparoscopic cholecystectomy on a 60kg patient. The patient was fasted for 8 hours before surgery, and the estimated surgical time was 2 hours. -Operation: Start infusing Sodium Lactate Ringer Injection 30 minutes before surgery. Calculate the total fluid replacement volume based on "basal requirement (4ml/kg/h)+preoperative loss (8 hours x 10ml/kg=800ml)+intraoperative physiological loss (2 hours x 10ml/kg=120ml)", with a total fluid replacement volume of approximately 4 x 60 x 2+800+120=1360ml and an infusion rate of 200ml/h.

- Result: Intraoperative blood pressure was maintained at 110-130/70-80mmHg, urine output was 40ml/h, and 2-hour postoperative blood gas analysis showed a pH of 7.38 (normal range 7.35-7.45), without dehydration or volume overload.
③ Key ingredients and precise ratio: Each drop is "just right". The efficacy of Sodium Lactate Ringer depends on strict ingredient ratios. The Chinese Pharmacopoeia (2020 edition, Part II) clearly specifies its composition and content (calculated per 100ml): - Sodium Chloride (NaCl): 0.6g (providing Na ⁺ 10.3mmol/L, Cl ⁻ 10.3mmol/L) - Potassium Chloride (KCl): 0.03g (providing K ⁺ 0.4mmol/L) - Calcium Chloride (CaCl ₂ · 2H ₂ O): 0.02g (providing Ca ² ⁺ 0.15mmol/L) - Sodium Lactate (C3H ₅ NaO3): 0.31g (Provide 2.8mmol/L lactate) - Key parameters: osmotic pressure of 273mOsm/L (similar to plasma osmotic pressure of 280310mOsm/L), pH value of 6.0-7.5 (weakly acidic, reduces venous irritation), and each bottle size is usually 250ml, 500ml, or 1000ml (500ml is commonly used clinically for easy control of fluid replacement volume). ④ Quality Control: The "Safety Line" from Production to Use To ensure clinical safety, Sodium Lactate Ringer Injection needs to undergo multiple strict tests, among which the osmotic pressure molar concentration test is one of the core indicators (directly affecting the fluid balance effect): - Testing Method: According to General Rule 0632 of the Chinese Pharmacopoeia "Determination of osmotic pressure molar concentration method", the freezing point lowering method is used (principle: the osmotic pressure of the solution is proportional to the freezing point lowering value). -Operation steps: Take 5ml of the test sample, inject it into the osmolality meter, read the freezing point drop value, and calculate the osmolality (formula: osmolality (mOsmol/kg)

=freezing point drop value (℃) ÷ 1.858). -Qualification criteria: The measured value should be within the range of 260-290mOsmol/kg (ensuring isotonic with plasma to avoid hemolysis or cell dehydration); Three bottles are randomly selected from each batch for testing, and only those that meet the standards can be released.
⑤ Environmental adaptability: Sodium lactate Ringer injection, a "stable partner" for high temperature, grassroots, and emergency scenarios, has strong adaptability to storage and use environments, especially suitable for the following scenarios: - High temperature environmental stability: The transportation and storage temperature should be controlled at 2-30 ℃ (to avoid freezing, which may cause component precipitation or container rupture). In high temperature areas in summer (such as South China, where the daily average temperature is above 35 ℃), cold chain vehicles should be used for transportation (carriage temperature ≤ 30 ℃), stored away from direct sunlight, and used up within 24 hours after opening the box. -Adaptation to primary healthcare institutions: No special storage equipment (such as refrigeration) is required. Ordinary pharmacies can store on shelves at room temperature, making it suitable for emergency use in grassroots units such as township health centers and community clinics (such as heatstroke and trauma fluid replacement during busy farming seasons). -Quick activation at emergency sites: packaged in glass infusion bottles or polypropylene infusion bags, it supports immediate use without the need for preheating or dilution (except for special cases where dilution is required, it is usually directly administered intravenously), and can meet the "minute level" fluid replacement needs in emergency situations such as car accident scenes and earthquake rescue. Summary: Sodium lactate Ringer injection has become the "cornerstone drug" of clinical liquid therapy by accurately supplementing body fluids, balancing electrolytes, and regulating acidity and alkalinity. Its strict ingredient ratio, reliable quality control, and extensive environmental adaptability make it play an irreplaceable role in emergency rescue, perioperative management, intensive care, and other scenarios. When using, the dosage and speed should be adjusted according to the patient's specific condition (such as degree of dehydration, heart function), and electrolyte and acid-base indicators should be monitored to ensure safety and effectiveness.