Application: | Internal Medicine |
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Usage Mode: | Injection |
Suitable for: | Adult |
State: | Liquid |
Shape: | Injection |
Type: | Biological Products |
Samples: |
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Customization: |
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1. Water loss caused by various reasons, including hypotonicity, isotonicity and hypertonicity.
2. In hypertonic nonketotic coma, the application of isotonic or hypotonic sodium chloride can correct dehydration and hypertonic state.
3. Low-chlorine metabolic alkalosis.
4. Externally use normal saline to flush eyes and wash wounds.
5. Water bladder for obstetrics to induce labor.
[Dosage]
1. Hypertonic water loss: The osmotic concentration of brain cells and cerebrospinal fluid increases in patients with hypertonic water loss. If the sodium concentration and osmotic concentration of plasma and extracellular fluid drop too quickly, brain edema may be caused. Therefore, it is generally believed that within 48 hours of the beginning of treatment, plasma sodium concentration does not drop more than 0.5 mmol/L per hour. If the patient has shock, sodium chloride injection should be given first, and the colloid should be supplemented as appropriate. After the shock is corrected, serum sodium>155mmol/L, plasma osmotic concentration>350mOSm/L, 0.6% hypotonic sodium chloride injection can be given. When the plasma osmotic concentration is <330mO5m/L, switch to 0.9% sodium chloride injection. The total amount of fluid replacement is calculated according to the following formula as a reference:
Generally, half of the amount will be replenished on the first day, and the remaining amount will be replenished in the next 2 to 3 days, and adjusted according to the cardiopulmonary and kidney function.
2. Isotonic water loss: In principle, give isotonic solutions, such as 0.9% sodium chloride injection or compound sodium chloride injection, but the chlorine concentration of the above solution is significantly higher than that of plasma, and large amounts of use alone can cause hyperchloremia. Therefore, 0.9% sodium chloride injection and 1.25% sodium bicarbonate or 1.86% (1/6 M) sodium lactate can be prepared at a ratio of 7:3 and then refilled. The latter has a chlorine concentration of 107mmol/L and can correct metabolic acidosis. The amount of replenishment can be calculated based on body weight or hematocrit as a reference. Calculated by body weight: fluid supplement (L)=(weight loss (kg)×142)/154; calculated by hematocrit:
The amount of fluid replacement (L) = (actual hematocrit-normal hematocrit) × body weight (Kg) × 0.2/normal hematocrit. Normal red blood cell pressure
It is 48% for males and 42% for females.
3. Hypotonic water loss: In severe hypotonic water loss, the solute in brain cells is reduced to maintain cell volume. If the treatment causes the plasma and extracellular fluid sodium concentration and osmotic concentration to rise rapidly, it can cause brain cell damage. It is generally believed that when blood sodium is lower than 120mmol/L, the rate of increase in blood sodium will be 0.5mmol/L per hour and not more than 1.5mmol/L per hour.
When the blood sodium is lower than 120mmol/L or symptoms of the central nervous system occur, 3%~5% sodium chloride injection can be instilled slowly, and it is generally required to increase the blood sodium concentration to more than 120mmol/L within 6 hours. Sodium supplementation (mmol) = [142-actual blood sodium concentration (mmol/L)] × body weight (Kg) × 0.2. When the blood sodium rises to above 120~125mmol/L, you can switch to isotonic solution or isotonic solution and add hypertonic glucose injection or 10% sodium chloride injection as appropriate.
4. Low-chlorine alkalosis: give 0.9% sodium chloride injection or compound sodium chloride injection (ringer's solution) 500~1000ml, and decide the dosage according to the situation of alkalosis.
5. External use: Wash the wound with physiological sodium chloride solution and rinse the eyes.
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