Hartmann Solution

Hartmann’s Solution (also known as Ringer’s Lactate) is used for:

• Fluid and electrolyte replacement in dehydration due to burns, trauma, surgery, or excessive fluid loss.
• Treatment of mild to moderate metabolic acidosis, especially when associated with dehydration or fluid loss.
• Replacement of extracellular fluid where sodium, potassium, calcium, and chloride are required in balanced amounts.
• Perioperative fluid management during surgery to maintain fluid balance.
• Shock and hypovolemia caused by blood loss, plasma loss, or severe diarrhea/vomiting.
• As a vehicle for drug delivery when compatible with medications for IV administration.

রেজিস্টার্ড চিকিৎসকের নির্দেশনা অনুযায়ী ঔষধ সেবন করুন।

This is a sterile solution containing essential electrolytes and sodium lactate.

Each 100 ml of solution contains:

• Sodium Chloride BP – 0.6 g
• Potassium Chloride BP – 0.04 g
• Calcium Chloride BP – 0.027 g
• Sodium Lactate 50% solution USP – equivalent to 0.32 g of Sodium Lactate

Electrolyte content per 1 litre of solution:

• Sodium – 131 mmol
• Potassium – 5 mmol
• Calcium – 2 mmol
• Bicarbonate (as lactate) – 29 mmol
• Chloride – 111 mmol

Hartmann’s Solution is administered only by intravenous (IV) infusion.

Adults:

• Usual dose: 500 ml to 3 liters per day, depending on fluid and electrolyte requirements.
• Infusion rate: 2–3 ml/kg/hour, adjusted according to clinical response, urine output, and laboratory results.

Children:

•  Dose: 20–100 ml/kg/day, depending on age, body weight, and clinical condition.
• Must be infused slowly under careful monitoring.

Elderly:

• Same as adult dosing, but the infusion should be slower with careful monitoring to prevent fluid overload, especially in patients with kidney or heart problems.

Surgical, trauma, or burn patients:

• Dose and infusion rate depend on fluid loss, blood loss, and electrolyte balance.
• Continuous monitoring of electrolytes, acid–base balance, and fluid status is required.

Special conditions:

• Kidney or liver impairment: Lower doses may be needed.
• Heart failure or edema: Administer slowly with strict monitoring to avoid overload.

রেজিস্টার্ড চিকিৎসকের নির্দেশনা অনুযায়ী ঔষধ সেবন করুন।

Hartmann’s Solution is an isotonic crystalloid fluid composed primarily of sodium chloride, sodium lactate, potassium chloride, and calcium chloride in water. It restores intravascular volume and electrolyte balance by replenishing extracellular fluid losses. The lactate component serves as a bicarbonate precursor; it is metabolized in the liver to bicarbonate, which helps buffer metabolic acidosis. The balanced electrolyte composition closely mimics plasma, reducing the risk of electrolyte disturbances and acid-base imbalances associated with other intravenous fluids.

• Absorption: Administered intravenously; immediate availability in circulation.
• Distribution: Distributes primarily in the extracellular fluid compartment, expanding plasma and interstitial volumes.
• Metabolism: Lactate metabolized in the liver to bicarbonate, aiding acid-base balance.
• Excretion: Electrolytes are excreted via the kidneys; fluid balance regulated by renal function.
• Onset of Action: Rapid; effects seen within minutes of infusion.
• Half-life: Depends on patient’s fluid status and renal function; generally cleared within hours as fluid equilibrates and is excreted.

• Pregnancy: Generally considered safe as it replaces essential fluids and electrolytes; no known teratogenic effects.
• Lactation: Safe during breastfeeding; does not accumulate or pass significantly into breast milk.
• Data: No significant adverse effects reported in pregnancy or lactation when used appropriately.

• Primary Class: Intravenous fluid therapy
• Subclass: Balanced crystalloid solution

• Known hypersensitivity to any component of Hartmann’s Solution.
• Severe hyperkalemia or hypercalcemia.
• Patients with alkalosis where bicarbonate precursors are contraindicated.
• Severe renal impairment with fluid overload risk.
• Congestive heart failure with fluid retention.

• Monitor for signs of fluid overload, especially in patients with cardiac or renal dysfunction.
• Use cautiously in patients with impaired liver function due to lactate metabolism.
• Monitor electrolytes regularly to avoid hyperkalemia or hypercalcemia.
• Avoid rapid infusion in patients with risk of pulmonary edema.
• Monitor acid-base status, particularly in patients with severe metabolic disturbances.
• Ensure aseptic technique during administration to prevent infections.

• Common:
• Injection site reactions (phlebitis, pain).
• Electrolyte imbalances if improperly administered.
• Rare/Serious:
• Fluid overload leading to pulmonary edema or heart failure exacerbation.
• Hyperkalemia or hypercalcemia causing cardiac arrhythmias.
• Metabolic alkalosis in predisposed patients.
• Allergic reactions (rare).

• May interact with potassium-sparing diuretics or ACE inhibitors increasing risk of hyperkalemia.
• Concurrent use with calcium-containing solutions and blood transfusions (citrate anticoagulated) may cause precipitation; avoid mixing.
• Drugs affecting acid-base balance may require adjustment of fluid therapy.
• Monitor closely when administered with nephrotoxic drugs.

• Current guidelines favor balanced crystalloids like Hartmann’s Solution over normal saline for volume resuscitation to reduce risk of hyperchloremic metabolic acidosis.
• Recommended in enhanced recovery after surgery (ERAS) protocols and sepsis management for balanced fluid resuscitation.
• Emphasis on individualized fluid therapy based on dynamic assessment of fluid responsiveness.
• Monitoring protocols for electrolyte and acid-base status during large volume infusions.

• Store at controlled room temperature, between 20°C and 25°C (68°F to 77°F).
• Protect from freezing and excessive heat.
• Keep container tightly closed and protected from light.
• Do not use if solution is discolored or contains precipitate.
• Use aseptic technique when accessing the solution.