Sodium chloride

Sodium chloride is an electrolyte supplement. Sodium and chloride are important electrolytes in the body, mainly present in extracellular fluid, and play a very important role in maintaining normal blood and extracellular fluid volume and osmotic pressure. The normal serum sodium concentration is 135-145mmol/L, accounting for 92% of plasma cations and 90% of total osmotic pressure, so the amount of plasma sodium plays a decisive role in osmotic pressure. The normal serum chloride concentration is 98-106mmol/L. Sodium and chloride ions in the human body are mainly regulated by the hypothalamus, posterior pituitary and kidneys to maintain the stability of body fluid volume and osmotic pressure.

Sodium chloride

Water loss due to various reasons, including hypotonic, isotonic and hypertonic water loss; hyperosmotic non-ketotic diabetic coma, hypochloremic metabolic alkalosis; external use of normal saline for flushing eyes and washing wounds, etc.; also used for water bag induction of labor in obstetrics.

1. Hypertonic dehydration During hypertonic dehydration, the osmotic concentration of the patient's brain cells and cerebrospinal fluid increases. If the treatment causes the plasma and extracellular fluid sodium concentration and osmotic concentration to drop too quickly, brain edema may occur. Therefore, it is generally believed that within the first 48 hours of treatment, the plasma sodium concentration should not drop by more than 0.5mmol/L per hour. If the patient is in shock, 0.9% sodium chloride injection should be given first, and colloid should be supplemented as appropriate. When the shock is corrected, the blood sodium is 155mmol/L, and the plasma osmotic concentration is 350mOsm/L, 0.6% hypotonic sodium chloride injection can be given. When the plasma osmotic concentration is <330mOsm/L, 0.9% sodium chloride injection should be used instead. The total amount of fluid replacement should be calculated according to the following formula for reference: [blood sodium concentration (mmol/L) - 142] Required fluid replacement (L) = ――――――――――――――――― ×0.6× body weight (Kg) Blood sodium concentration (mmol/L) Generally, half of the amount is replenished on the first day, and the rest is replenished within the next 2 to 3 days, and it is adjusted as appropriate according to cardiopulmonary and renal function. 2. Isotonic dehydration principle: Isotonic solution is given, such as 0.9% sodium chloride injection or compound sodium chloride injection, but the chloride concentration of the above solution is significantly higher than that of plasma. Large-scale use alone can cause hyperchloremia. Therefore, 0.9% sodium chloride injection and 1.25% sodium bicarbonate or 1.86% (1/6M) sodium lactate can be prepared in a ratio of 7:3 and then replenished. The latter has a chloride concentration of 107mmol/L and can correct metabolic acidosis. The amount of fluid replenishment can be calculated by body weight or hematocrit for reference. ① Calculated by body weight: fluid replenishment (L) = (weight loss (kg) x 142) / 154; ② Calculated by hematocrit: fluid replenishment (L) = (actual hematocrit - normal hematocrit x body weight (kg) x 0.2) / normal hematocrit. Normal hematocrit is 48% for men and 42% for women. 3. Hypotonic dehydration In severe hypotonic dehydration, the solutes in brain cells decrease to maintain cell volume. If the treatment causes the plasma and extracellular fluid sodium concentration and osmotic concentration to rise rapidly, brain cell damage may occur. It is generally believed that when blood sodium is lower than 120mmol/L, the treatment will increase the blood sodium rate by 0.5mmol/L per hour, not exceeding 1.5mmol/L per hour. When blood sodium is lower than 120mmol/L or central nervous system symptoms occur, 3% to 5% sodium chloride injection can be given slowly by drip. Generally, it is required to raise the blood sodium concentration to above 120mmol/L within 6 hours. Sodium supplement amount (mmol/L) = [142-actual blood sodium concentration (mmol/L)] x body weight (kg) x 0.2. When the blood sodium rises to above 120-125mmol/L, isotonic solution can be used instead or hypertonic glucose injection or 10% sodium chloride injection can be added to isotonic solution as appropriate. 4. Hypochloremic alkalosis: 500-1000ml of 0.9% sodium chloride injection or compound sodium chloride injection (Ringer's solution) is given, and the dosage is determined according to the alkalosis condition. 5. For external use: Wash wounds and rinse eyes with physiological sodium chloride solution.

Generally, there are no adverse reactions. Improper use may cause: 1. Too fast or excessive administration may cause high blood pressure, headache, and dizziness. 2. Weight gain and edema. 3. Accelerated heart rate, chest tightness, difficulty breathing, and wheezing in the lungs.

The following patients are contraindicated for use: (1) heart failure; (2) pulmonary edema; (3) cerebral edema, increased intracranial pressure; (4) ascites due to cirrhosis; (5) oliguria in acute renal failure; patients with chronic renal failure who do not respond well to diuretics; and (6) hypernatremia.

When used as a drug solvent or diluent, attention should be paid to the incompatibility between drugs. (1) When used with amphotericin B, it may cause turbidity, precipitation, or discoloration. (2) It should not be used with reserpine, polymyxin B sulfate, polymyxin E sulfate, or cephalosporin I.

Sealed storage. 24 months

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