Crystalloid solution has specific properties. It is actively used for surgery and therapeutic purposes. Due to its active composition, it quickly penetrates into the tissues, blood, regulating acid-base and water-electrolyte metabolism.
What it is?
Colloidal and crystalloid solutions are also called blood substitutes, since they replace or normalize the lost blood functions. They must meet certain requirements:
- safety (not to be toxic);
- functionality (possess healing properties);
- stability (should not enhance its effect upon repeated administration).
Blood substitutes are divided into two groups: colloidal and crystalloid solutions. The former include Lactosol, Disol, Acesol, and the latter include Polyglukin, Reoglyuman, Volekam, Infuzol and others.
Indications
A crystalloid solution is used to replenish the volume of circulating blood if the bleeding rate is small and the blood loss is less than fifteen percent. In this case, Ringer's solution is used. Crystalloids are used as solvents for drugs. The most common are 5% glucose, Sterofundin, that is, weak hypertonic and isotonic solutions. Crystalloids are needed to compensate for the lack of electrolytes and energy, as a hemostatic agent.
Colloids are designed to alter 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 Venozole, Gelofusin, Reftan, Stabizol, Voluven, Perftoran. Sometimes in conditions of slow blood flow, crystalloid solutions are used in conjunction with colloidal. 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 basis of separation is belonging to inorganic and organic substances and properties. All solutions must necessarily be fluid, safe for health, non-toxic, easily dosed, neutral for different drugs, stable. Their basis is NaCl. Ringer-Lock solutions and electrolytes (hypertonic and hypotonic) are referred to crystalloids. Blood substitutes are divided according to the mechanism of therapeutic action:
- Hemodynamic.
- Detoxification.
- Parenteral.
- Regulators.
- Blood substitutes that carry oxygen.
- Infusion antihypoxants.
- Blood substitutes of complex action.
- Colloids.
- Crystalloids.
Colloids include natural substitute solutions (plasma, albumin) and synthetic; crystalloid (salt) blood substitutes include hypotonic, hypertonic and isotonic solutions. Colloids fill the volume of extracellular fluid, support it during surgery, treat moderate hypovolemia.
Contraindications
Despite the good tolerance of crystalloids by the human body, they have contraindications depending on the composition. Isotonic saline sodium chloride solution, it contains nine grams of the basic substance. In relation to blood plasma, it is hypertonic, the reaction is weakly 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 incomprehensible etiology. The K + ions in the solution can adversely affect the adrenal glands and kidneys if the patient has a dysfunction of these organs.
The "Normasol" solution, in comparison with the previous one, has more pronounced therapeutic properties. The drug is known for its vasodilating effect, but can prevent the occurrence of vasoconstriction, which maintains normal blood pressure against hypovolemia. In addition, Ringer's solution is not partially and relatively compatible with such drugs as Ampicillin, Vibramycin, Minocycline, Amikacin, Ornid, Anaprilin, Urokinase, etc. For intravenous use glucose solution. It supports 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 organs affected by coronary artery disease. This primarily concerns the central nervous system.
How to use
Crystalloid solutions are suitable for infusion therapy and recovery of extracellular fluid loss. Most often they are used for large blood loss. For example, with hemorrhagic shock, the solution is administered in a volume of 3 ml for each milliliter of blood loss in a ratio of 3: 1. For adult patients, the substance is injected in a jet of one liter. The amount of solution is adjusted taking into account age, as well as the presence of cardiovascular diseases. In order to avoid overdose, invasive monitoring is mandatory.
For children, the solution is injected jet at a dose of 20 ml / kg. After the introduction of each dose of the drug, the condition of the child is evaluated. If hemodynamic parameters are unstable after three doses, the doctor urgently begins a blood transfusion. If suspected of internal bleeding, the patient is sent to the operating room.
Features
Crystalloid solution belongs to the group of blood substitutes. This includes sugar and electrolyte infusions. 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 conditionally divided into several groups:
- substitute (if a person has lost a lot of blood and requires compensation for electrolytes and water);
- basic (provide balance);
- corrective (restore the imbalance of ions and water).
Crystalloids provide the passage of fluid into the extracellular space, are rapidly excreted by the kidneys, have a limited effect and its duration, can provoke hypoxia, pulmonary and internal organs edema. With caution, they should be used in patients with heart and kidney diseases.
Side effects
Crystalloid solutions before intravenous administration must be checked for compliance. Usually they are easily tolerated by patients, do not affect immunity, internal organs (if there are no concomitant diseases), maintain electrolyte balance, but are able to cause hypertensive edema due to the rapid redistribution from blood vessels to cells and the need for 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 administered intravenously, the development of dilutionary coagulopathy and infection with the hepatitis virus (in rare cases) can be provoked. Allergic reactions sometimes become a side effect. A solution of getastarch 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.
A large volume of solution does not provoke blood coagulation problems. A dextran solution causes bleeding, reduces platelet aggregation, and promotes fibrinolysis. Sometimes anaphylactic reaction is observed in patients . The drug for the period of use may make it impossible to determine the blood group, provoke renal failure. The names of crystalloid solutions were obtained by their properties and composition, which includes the active substance.
Price
Colloidal 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 solution 10%, 400 ml costs 119 rubles. Colloidal solutions for the patient are expensive, and the positive effect exerted is not always justified.