Glucose and Sodium Chloride Injection 500ml

[Main ingredients]  25g glocuse, 4.5gsodium chloride

1, Usage and dosage of glucose
1. If the patient who is fed less or cannot eat due to some reasons, 10%~25% glucose injection can be given intravenously, and body fluid can be supplemented at the same time. The amount of glucose is calculated according to the required heat energy;
Glucose is the most important energy supply material for total intravenous nutrition therapy. In non protein heat energy, the ratio of energy supplied by glucose to fat is 2 ∶ 1. The specific dosage depends on the clinical heat demand According to the need for fluid infusion, glucose can be prepared into 25%~50% different concentrations. If necessary, add insulin, and add 1 unit of regular insulin for every 5~10g of glucose Because this product is often used with hypertonic solution, which is highly irritating to the vein and needs to be injected with fat emulsion, it is generally used with deep large veins, such as subclavian vein, internal jugular vein, etc;
3 Hypoglycemia, severe cases can be given 20~40ml intravenous injection of 50% glucose injection first;
4 Hunger ketosis, in severe cases, 5%~25% glucose injection is used intravenously, and 100g glucose per day can basically control the disease;
5. Water loss: 5% glucose injection was given intravenously for isotonic water loss;
Hyperkalemia can be reduced by 10%~25% injection, every 2~4g of glucose plus 1 unit of regular insulin infusion. However, this treatment only allows extracellular potassium ions to enter the cells, and the total potassium content in the body remains unchanged. If potassium excretion measures are not taken, hyperkalemia may still occur again;
7. Tissue dehydration hypertonic solution (usually 50% glucose injection) is rapidly injected intravenously for 20~50ml, but the effect is short. In clinical practice, attention should be paid to prevent hyperglycemia, which is rarely used at present When it is used to adjust the osmotic pressure of peritoneal dialysis solution, 20ml of 50% glucose injection, i.e. 10g glucose, can increase the osmotic pressure of 1L peritoneal dialysis solution by 55mOsm/kgH2O. That is, the osmotic pressure will increase by 55mOsm/kgH2O for every 1% increase in the glucose concentration in the dialysis solution.
2, Usage and dosage of sodium chloride
1. Hyperosmotic water loss
When hypertonic dehydration occurs, the osmotic concentration of brain cells and cerebrospinal fluid in patients increases. If the treatment makes the sodium concentration and osmotic concentration of plasma and extracellular fluid decrease too quickly, brain edema may occur. Therefore, it is generally believed that the plasma sodium concentration will decrease by no more than 0.5mmol/L per hour within 48 hours after treatment If the patient has shock, the sodium chloride injection should be given first, and colloids should be supplemented as appropriate. After the shock is corrected, 0.6% hypotonic sodium chloride injection can be given if the blood sodium is>155mmol/L and the plasma osmotic concentration is>350mOsm/L. When the plasma osmotic concentration is<330mOsm/L, 0.9% sodium chloride injection can be used instead The total amount of fluid infusion is calculated according to the following formula as a reference: the amount of fluid infusion required (L)=[blood sodium concentration (mmol/L) - 142] × zero point six × The body weight (kg), blood sodium concentration (mmol/L), is generally supplied in half on the first day, and the rest is supplied in the next 2 to 3 days, and adjusted according to the heart, lung and kidney functions;
2. Isotonic water loss
In principle, isotonic solutions, such as 0.9% sodium chloride injection or compound sodium chloride injection, are given, but the chlorine concentration of the above solutions is significantly higher than that of plasma. If used in large quantities alone, hyperchloremia may occur. Therefore, 0.9% sodium chloride injection and 1.25% sodium bicarbonate or 1.86% (1/6M) sodium lactate can be supplemented after being prepared at a ratio of 7 ∶ 3 The latter has a chlorine concentration of 107 mmol/L and can correct metabolic acidosis. The amount of supplement can be calculated according to body weight or hematocrit as a reference 1. Calculated by body weight: fluid infusion volume (L)=(weight loss (kg) × 142)/154; 2. Calculated by hematocrit: fluid supplement volume (L)=(actual hematocrit normal hematocrit × Weight (kg) × 0.2)/Normal hematocrit Normal hematocrit was 48% in males and 42% in females;
3. Low permeability water loss
In severe hypotonic dehydration, the solute in brain cells decreases to maintain the cell volume. If the concentration of sodium in plasma and extracellular fluid and osmotic concentration rise rapidly after treatment, brain cells may be damaged It is generally believed that when the blood sodium is lower than 120 mmol/L, the treatment will increase the blood sodium at 0.5 mmol/L per hour, not more than 1.5 mmol/L When blood sodium is lower than 120 mmol/L or central nervous system symptoms occur, 3%~5% sodium chloride injection can be given slowly It is generally required to increase the blood sodium concentration to more than 120 mmol/L within 6 hours Amount of sodium supplement (mmol/L)=[142 - actual blood sodium concentration (mmol/L)] × Weight (kg) × 0.2. When the blood sodium rises to more than 120~125mmol/L, hypertonic glucose injection or 10% sodium chloride injection can be added to isotonic solution or isotonic solution as appropriate;
4 alkalosis
Give 0.9% sodium chloride injection or compound sodium chloride injection (Ringer's solution) 500~1000ml, and then determine the dosage according to the alkalosis.