Crystalloid solution has specific properties. It is actively used in surgery and therapeutic purposes. Due to its active composition, it quickly penetrates into tissues, blood, regulating acid-base and water-electrolyte metabolism.
What is this?
Colloid and crystalloid solutions are also called blood substitutes, as they replace or normalize lost blood functions. They must meet certain requirements:
- safety (not be toxic);
- functionality (have medicinal properties);
- stability (should not increase with repeated administration).
Blood substitutes are divided into two groups: colloidal and crystalloid solutions. The first include "Laktosol", "Disol", "Atsesol", the second - "Polyglukin", "Reogluman", "Volekam", "Infuzol" and others.
Indications
Crystalloid solution is used to replenish the volume of circulating blood if the speedbleeding is small, and blood loss is less than fifteen percent. In this case, Ringer's solution is used. Crystalloids are used as drug solvents. The most common are 5% glucose, "Sterofundin", that is, slightly hypertonic and isotonic solutions. Crystalloids are needed to compensate for the lack of electrolytes and energy, as a hemostatic agent.
Colloids are designed to change the osmotic pressure in a blood vessel. This stabilizes the volume of circulating blood and hemodynamics. They normalize blood pressure and keep it normal. Colloids include Venozol, Gelofuzin, Refortan, Stabizol, Voluven, Perftoran. Sometimes, in conditions of slow blood flow, crystalloid solutions are used in conjunction with colloidal solutions. They reduce blood viscosity, restore blood circulation, improve hemodynamics, nourish tissues and organs, restore hemoglobin and keep it normal.
Classification
Infusion substances have a working classification. They are divided into preparations of blood components, crystalloid solutions and colloids. The division is based on belonging to inorganic and organic substances and properties. All solutions must necessarily be fluid, safe for he alth, non-toxic, easily dosed, neutral for various drugs, and stable. They are based on NaCl. Crystalloids include Ringer-Lock solutions, electrolytes(hypertonic and hypotonic). Blood substitutes are divided according to the mechanism of therapeutic action:
- Hemodynamic.
- Detoxification.
- Parenteral.
- Regulators.
- Blood substitutes that carry oxygen.
- Infusion antihypoxants.
- Complex action blood substitutes.
- Colloids.
- Crystalloids.
Colloids include natural replacement solutions (plasma, albumin) and synthetic, crystalloid (s alt) blood substitutes - hypotonic, hypertonic and isotonic solutions. Colloids replenish the volume of extracellular fluid, maintain it during surgery, and treat mild hypovolemia.
Contraindications
Despite the good tolerance of crystalloids by the human body, they have contraindications depending on the composition. Isotonic sodium chloride saline solution, it contains nine grams of the main substance. In relation to blood plasma, it is hypertonic, the reaction is slightly acidic. If you enter a large amount of sodium chloride, you can provoke metabolic acidosis. Ringer's solution with lactate has a physiological composition. The drug is combined, has a wide scope, especially in case of injuries of unknown etiology. The K+ ions in the solution can negatively affect the adrenal glands and kidneys if the patient has dysfunction of these organs.
The "Normasol" solution, in comparison with the previous one, has more pronounced therapeutic properties. The drug is known for its vasodilatory effect, but may prevent the occurrence of vasoconstriction, which maintains blood pressure in the normal range against the background of hypovolemia. In addition, Ringer's solution is partially and relatively incompatible with such drugs as Ampicillin, Vibramycin, Minocycline, Amikacin, Ornid, Anaprilin, Urokinase, etc. For intravenous administration, use glucose solution. It maintains the level of carbohydrates, ensures the normal functioning of the central nervous system in patients with disorders of the nervous system. However, glucose infusions can provoke the appearance of lactic acid in the organs affected by coronary disease. First of all, this concerns the central nervous system.
How to use
Suitable crystalloid solutions for infusion therapy and replacement of extracellular fluid loss. Most often they are used for large blood loss. For example, in hemorrhagic shock, the solution is administered in a volume of 3 ml per milliliter of blood loss in a ratio of 3:1. For adult patients, the substance is injected in a stream of one liter. The amount of solution is adjusted taking into account age, as well as the presence of cardiovascular diseases. Invasive monitoring is mandatory to avoid overdose.
For children, the solution is administered by jet at a dose of 20 ml/kg. After the introduction of each dose of the drug, the condition of the child is assessed. If after three doses the hemodynamic parameters are unstable, the doctor urgently starts a blood transfusion. If internal bleeding is suspected, the patient is referred to the operating room.
Features
Crystalloid solution belongs to the group of blood substitutes. This includes infusion substances of sugars and electrolytes. Thanks to them, water, electrolyte and acid balances are restored in the body. Solutions from this group quickly pass from the vessels into the cells, depending on the composition. They are conventionally divided into several more groups:
- replacing (if a person has lost a lot of blood and needs replacement of electrolytes and water);
- basic (provide balance);
- corrective (restor the imbalance of ions and water).
Crystalloids ensure the passage of fluid into the extracellular space, are quickly excreted by the kidneys, have a limited effect and its duration, can provoke hypoxia, edema of the lungs and internal organs. They should be used with caution in patients with heart and kidney disease.
Side effects
Crystalloid solutions before intravenous administration must be checked for compliance. Usually they are easily tolerated by patients, do not affect the immune system, internal organs (if there are no concomitant diseases), maintain electrolyte balance, but can cause hypertonic edema due to rapid redistribution fromvessels into cells and the need to administer large doses. Colloids are often used in medical practice.
The most common include a solution of albumin 25% and 5%, hetastarch 6% and dextran-40. If a large volume of colloids is injected intravenously, dilutional coagulopathy and infection with the hepatitis virus (in rare cases) can be provoked. Side effects are sometimes allergic reactions. Hetastarch solution is able to increase the level of amylase in the blood several times. This condition persists for five days, but does not lead to pancreatitis. It is important to monitor the patient's condition during treatment.
The large volume of the solution does not provoke blood clotting problems. A solution of dextrans causes bleeding, reduces platelet aggregation, and promotes fibrinolysis. Sometimes patients experience an anaphylactic reaction. The drug for the period of use can make it impossible to determine the blood type, provoke renal failure. Crystalloid solutions are named after their properties and composition, which includes the active substance.
Price
Colloid and crystalloid solutions are often used in medicine. Their cost depends on the name of the product, manufacturer, volume. For example, a bottle of Reopoliglyukin 10% solution, 400 ml costs 119 rubles. Colloidal solutions are expensive for the patient, and the positive effect is not always justified.
