(1989; 60 pages) [French]
Group: intravenous infusion fluid
Injectable isotonic solution: 9 mg/ml (0.9%); Na+ 154 mmol/litre, Cl- 154 mmol/litre
Sodium is the major extracellular cation. Maintenance of physiological concentrations is vital to effective regulation of the osmotic pressure of blood and tissues.
• Preoperative correction of fluid and sodium depletion.
• Replacement of extracellular fluid during surgery.
• Initial restoration of circulatory volume in hypovolaemic shock.
Individual fluid requirements must be determined on the basis of clinical and, whenever possible, electrolyte monitoring. As a general guide in adults:
Preoperative fluid replacement: 50 ml/minute as an alternative to compound solution of sodium lactate.
Fluid replacement during surgery: 5 ml/minute as an alternative to compound solution of sodium lactate.
Acute hypovolaemic shock: as an alternative to compound solution of sodium lactate until vasoconstriction disappears and systolic blood pressure reaches 100 mmHg (13.3 kPa).
Patients must be carefully monitored throughout the infusion for signs of intra-vascular overload, particularly when large volumes are administered rapidly. Should this occur, the infusion must be slowed or suspended and, if necessary, a rapidly acting diuretic administered (for example furosemide 40 mg i.v).
Unduly rapid replacement can lead to pulmonary oedema.
Excessive infusion may result in sodium retention. Symptoms of hypernatraemia include restlessness, weakness, thirst, dry swollen tongue, flushing of the skin, pyrexia and tachycardia.
Sodium chloride solution should be stored in sealed containers.