Potassium chloride with calcium chloride sodium chloride and sodium lactate

How it works

It replenishes extracellular volume and electrolytes; the lactate is metabolised in the liver to bicarbonate, providing a buffering effect that helps counter metabolic acidosis.

Prescribing in practice

• The potassium content means it should be avoided or used cautiously in hyperkalaemia and significant renal impairment, where potassium can accumulate and cause arrhythmias.
• The calcium content makes it unsuitable for administration through the same line as citrated blood products and incompatible with certain drugs.
• Lactate metabolism may be impaired in severe hepatic dysfunction or lactic acidosis, and the solution should be used cautiously in these situations and in fluid-overload states.

Monitoring

Monitor electrolytes, acid-base status, fluid balance and renal function during administration, particularly in hepatic or renal impairment.

Counselling the patient

• Explain that this balanced fluid replaces salts and water and helps correct acid levels in the blood.
• Report swelling, breathlessness or palpitations during the infusion.

Evidence & guidelines

Compound sodium lactate (Hartmann's solution) is a long-established balanced crystalloid widely used for perioperative and resuscitation fluid therapy.