Usage of Sodium Lactate
Table of Contents 1. Overview of Sodium Lactate (1) Basic Information of Sodium Lactate (2) Mechanism of Action of Sodium Lactate 2. Application of Sodium Lactate (1) Metabolic Acidosis (2) Hyperkalemia (3) Other Applicable Scenarios 3. Usage of Sodium Lactate (1) Route of Administration (2) Dose Determination (3) Medication Precautions 4. Case Analysis of Sodium Lactate Usage (1) Metabolic Acidosis Cases (2) Hyperkalemia Cases 5. Limitations and Improvement Directions of Sodium Lactate Usage (1) Limitations (2) Improvement Directions
Main Text 1. Overview of Sodium Lactate (1) Basic Information of Sodium Lactate According to experience, sodium lactate is an organic compound that can be used in... The medical field has a wide range of applications. It is usually a colorless or almost colorless clear viscous liquid that can be mixed with water, ethanol, or glycerol at will. In clinical practice, the commonly used sodium lactate preparation is sodium lactate injection, which is generally an 11.2% hypertonic solution.

（2） The mechanism of action of sodium lactate: After entering the human body, sodium lactate is converted into pyruvic acid by hepatic lactate dehydrogenase under aerobic conditions. It is then oxidized and decarboxylated by the tricarboxylic acid cycle to produce carbon dioxide, which is then converted into bicarbonate ions to correct metabolic acidosis. For example, in patients with metabolic acidosis caused by lactate accumulation due to shock, hypoxia, and other reasons, sodium lactate can regulate the acid-base balance in the body through the above mechanism.
2、 Application of Sodium Lactate (1) Metabolic Acidosis In practical work, metabolic acidosis is one of the main applications of sodium lactate. Metabolic acidosis occurs when patients have too much acidic substances or too much loss of alkaline substances due to various reasons, such as severe diarrhea, renal failure, diabetes ketoacidosis, etc. At this point, sodium lactate can help correct acid-base imbalances. For example, there was once a patient with diabetes ketoacidosis whose blood pH dropped to 7.1 (the normal range was 7.35-7.45). After intravenous drip of appropriate amount of sodium lactate injection, the patient's blood pH gradually returned to the normal range after a period of treatment.
（2） Hyperkalemia is also one of the applicable scenarios for sodium lactate. When the serum potassium concentration exceeds 5.5 mmol/L, it will have a serious impact on important organs such as the heart. Sodium lactate can reduce serum potassium concentration by alkalizing extracellular fluid, promoting the entry of potassium ions into cells. A patient with chronic kidney failure had a blood potassium concentration of 6.2 mmol/L and exhibited symptoms such as arrhythmia. The doctor administered intravenous infusion of sodium lactate injection, combined with other treatment measures, and the patient's blood potassium concentration gradually decreased, and the symptoms of arrhythmia were also relieved.
（3） In addition to the above two situations, sodium lactate is also used in some specific surgeries. For example, in extracorporeal circulation surgery, metabolic acidosis may occur due to factors such as blood dilution and low temperature. In this case, sodium lactate can be used to maintain acid-base balance.

3、 The administration route of sodium lactate is generally through intravenous infusion. This is because intravenous infusion can quickly allow drugs to enter the bloodstream and exert their effects quickly. In practical operation, it is necessary to choose the appropriate infusion speed and volume according to the specific situation of the patient.
（2） The determination of the dosage of sodium lactate requires comprehensive consideration of factors such as the patient's condition, weight, and degree of acid-base imbalance. Generally speaking, for patients with metabolic acidosis, the required dose of sodium lactate can be calculated according to the formula: required sodium lactate (ml)=[normal carbon dioxide binding capacity (mmol/L) - measured carbon dioxide binding capacity (mmol/L)] x body weight (kg) x 0.3. For example, for a patient weighing 60kg, the measured carbon dioxide binding capacity is 15mmol/L. If the normal carbon dioxide binding capacity is calculated as 25mmol/L, the required amount of sodium lactate is (25-15) × 60 × 0.3=180ml. However, in practical applications, usually 1/2-2/3 of the calculated amount is given first, and then the dosage is adjusted based on the patient's reaction and follow-up results.
（3） There are many precautions when using sodium lactate. Firstly, for patients with liver dysfunction, shock hypoxia, right heart failure, etc., due to the decreased metabolic capacity of the liver for lactate, sodium lactate should be used with caution to avoid exacerbating lactate accumulation. Secondly, during the medication process, it is necessary to closely monitor the patient's acid-base balance indicators, electrolyte levels, etc., such as blood pH value, carbon dioxide binding capacity, blood potassium, blood sodium, etc. In addition, sodium lactate should not be mixed with solutions containing calcium salts, otherwise precipitation may occur.
4、 Case Analysis of Sodium Lactate Usage (1) Metabolic Acidosis Case In 2023, a hospital admitted a patient with metabolic acidosis caused by severe diarrhea. The patient was mentally lethargic upon admission, breathing deeply and rapidly, with a blood pH value of 7.05 and a carbon dioxide binding capacity of 12mmol/L. The doctor calculated the required amount of sodium lactate based on the patient's weight (50kg), and first gave 1/2 of the calculated amount, which is (25-12) × 50 × 0.3 × 1/2=

97.5ml. It was diluted into an isotonic solution and administered intravenously. During the infusion process, closely monitor the patient's vital signs and acid-base balance indicators. After 2 hours of treatment, the patient's breathing gradually stabilized, and the blood pH value was rechecked to 7.2. Continuing to observe and adjust the dosage based on the re examination results, after one day of treatment, the patient's blood pH value returned to the normal range and the condition improved significantly.
（2） The case of hyperkalemia also occurred in 2023, when a patient with chronic kidney failure was admitted due to hyperkalemia. The patient's blood potassium concentration was 6.5 mmol/L, and the electrocardiogram showed typical high potassium symptoms. The doctor immediately administered intravenous infusion of sodium lactate injection, combined with medication such as calcium gluconate and insulin for treatment. During the infusion of sodium lactate, closely monitor the patient's blood potassium concentration and electrocardiogram changes. After 4 hours of treatment, the patient's blood potassium concentration decreased to 5.2 mmol/L, and the electrocardiogram gradually returned to normal.
5、 Limitations and improvement directions of sodium lactate usage (1) Limitations: The use of sodium lactate has certain limitations. Firstly, it needs to be metabolized by the liver under aerobic conditions to function effectively, so its effectiveness may not be ideal for patients with liver dysfunction, shock, and hypoxia. Secondly, the action of sodium lactate is relatively slow, and for severe acute acid-base imbalances, it may not be corrected in a timely manner. In addition, improper dosage control during use may lead to adverse reactions such as alkalosis.
（2） Improvement direction: In order to overcome the limitations of sodium lactate, it is possible to consider developing some new alkaline drugs that do not require liver metabolism and can act faster. In addition, in clinical applications, other treatment methods such as hemodialysis can be combined to improve treatment effectiveness. At the same time, strengthen monitoring and evaluation of patients, more accurately grasp the dosage and timing of sodium lactate use, and reduce the occurrence of adverse reactions.
In summary, sodium lactate is an important medication for correcting acid-base imbalances in clinical practice. However, when using it, it is necessary to choose the appropriate dosage and administration according to the specific situation of the patient, and closely monitor the patient's response to ensure the safety and effectiveness of the treatment. However, my understanding in this area may also be insufficient. Medicine is constantly evolving, and there may be better treatment plans and improvement measures waiting for us to discover.