塩化ナトリウム
**塩化ナトリウム**は、獣医療において水分補給、電解質バランスの調整、および薬物の希釈剤として使用される基本的な晶質液です。低張、等張（生理食塩水）、および高張の製剤があります。 > **臨床のポイント：** 高張食塩水はショック時の強力な血漿増量剤ですが、血清ナトリウム濃度の慎重なモニタリングと、その後の等張液の投与が必要です。
作用機序: Isotonic and hypertonic formulations expand **plasma volume** and replace lost extracellular fluid. Hypotonic formulations provide free water and may promote oedema formation. When used for fluid replacement, NaCl (0.45% and 0.9%) will expand the plasma volume compartment. → Compared with colloids, 2.5 to 3.0 times as much fluid must be given because the crystalloid is distributed to other fluid compartments.
動物種別の用量
- Intravenous fluid replacement (including hypercalcaemia or hyperchloraemic alkalosis) · Dose not specified in monograph · IV · As directed · As needed · Treatment of choice for hypercalcaemia or hyperchloraemic alkalosis.
- Shock (rapid blood volume expansion) · Rate must not exceed 1 ml/kg/min · IV · As directed · Preoperative period or acute crisis · Use hypertonic saline. Must monitor serum sodium and follow with isotonic crystalloid.
- Corneal oedema · Dose not specified in monograph · Topical · As directed · As needed · Use 5% hypertonic ophthalmic ointment.
- Hypoadrenocorticism (long-term management) · Dose not specified in monograph · PO · As directed · Long-term · Enteric-coated products may have unpredictable efficacy in dogs.
- Intravenous fluid replacement · Dose not specified in monograph · IV · As directed · As needed · Treatment of choice for hypercalcaemia or hyperchloraemic alkalosis.
- Shock (rapid blood volume expansion) · Rate must not exceed 1 ml/kg/min · IV · As directed · Preoperative period or acute crisis · Use hypertonic saline. Must monitor serum sodium and follow with isotonic crystalloid.
- Corneal oedema · Dose not specified in monograph · Topical · As directed · As needed · Use 5% hypertonic ophthalmic ointment.
用量は獣医療従事者向けの臨床リファレンスです。必ず最新の添付文書と個々の患者で確認してください。
投与経路
禁忌
- Dehydrated animals (Hypertonic saline)
- Hypovolaemic animals (Hypotonic solutions)
有害事象
- Peripheral oedema
- Hyperchloraemic acidosis (especially in compromised patients)
- Vagally mediated bradycardia (if hypertonic saline is administered >1 ml/kg/min)
- Stinging sensation (ophthalmic ointment)
モニタリング
- Serum sodium concentrations (especially before and after hypertonic saline)
- Acid-base status (monitor for acidosis)
- Heart rate (monitor for bradycardia during rapid hypertonic infusion)
- Hydration status and fluid balance
過量投与
Excessive administration of normal saline can increase the risk of **hyperchloraemic acidosis** and **peripheral oedema**. Administration of hypertonic saline at fluid rates >1 ml/kg/min can cause a **vagally mediated bradycardia**.
VetSheet の薬剤リファレンスは、獣医療従事者向けの臨床意思決定支援を目的としており、専門的判断やメーカーの最新添付文書に代わるものではありません。