Sodium lactate for fluid resuscitation: the preferred solution for the coming decades?

Crit Care. 2014 Jul 7;18(4):163. doi: 10.1186/cc13973.

Abstract

In a recent issue of Critical Care, 0.5 M sodium lactate infusion for 24 hours was reported to increase cardiac output in patients with acute heart failure. This effect was associated with a concomitant metabolic alkalosis and a negative water balance. Growing data strongly support the role of lactate as a preferential oxidizable substrate to supply energy metabolism leading to improved organ function (heart and brain especially) in ischemic conditions. Due to its sodium/chloride imbalance, this solution prevents hyperchloremic acidosis and limits fluid overload despite the obligatory high sodium load. Sodium lactate solution therefore shows many advantages and appears a very promising means for resuscitation of critically ill patients. Further studies are needed to establish the most appropriate dose and indications for sodium lactate infusion in order to prevent the occurrence of severe hypernatremia and metabolic alkalosis.

MeSH terms

  • Acid-Base Imbalance / etiology
  • Acid-Base Imbalance / prevention & control*
  • Acidosis / etiology
  • Acidosis / prevention & control
  • Alkalosis / prevention & control
  • Biomarkers
  • Cardiac Output / drug effects
  • Fluid Therapy / methods*
  • Heart Failure / drug therapy*
  • Humans
  • Hyperlactatemia / chemically induced
  • Hyperlactatemia / prevention & control
  • Hypernatremia / chemically induced
  • Hypernatremia / prevention & control
  • Hypokalemia / chemically induced
  • Hypokalemia / prevention & control
  • Prognosis
  • Sodium Lactate / administration & dosage
  • Sodium Lactate / adverse effects
  • Sodium Lactate / therapeutic use*
  • Stroke Volume / drug effects
  • Water-Electrolyte Balance / drug effects
  • Water-Electrolyte Imbalance / chemically induced*
  • Water-Electrolyte Imbalance / prevention & control

Substances

  • Biomarkers
  • Sodium Lactate