Sodium chloride additive solution is available as a preservative-free concentrate for injection in concentrations of 14.6 and 23.4% in various size containers.3860; 3861 A pharmacy bulk package may be available.3861 The 14.6% concentration contains sodium chloride 146 mg/mL and provides 2.5 mEq/mL of sodium and chloride ions.3860 The 23.4% concentration contains sodium chloride 234 mg/mL and provides 4 mEq/mL of sodium and chloride ions.3861
NOTE: Do not confuse these high concentration additive solutions with other sodium chloride products with lower concentrations.
Sodium chloride 0.45 and 0.9% infusion solutions are available in a variety of sizes from 25 to 1000 mL.3862 The 0.45 and 0.9% concentrations provide 77 and 154 mEq, respectively, of sodium and chloride per liter.3862
Sodium chloride 3 and 5% hypertonic infusion solutions are available in 500 mL flexible plastic containers.3863 The 3% concentration contains sodium chloride 30 g/L and provides 513 mEq/L of sodium and chloride ions.3863 The 5% concentration contains sodium chloride 50 g/L and provides 856 mEq/L of sodium and chloride ions.3863
pH
From 4.5 to 7.3860; 3861; 3862; 3863
Osmolarity
Sodium chloride additive solutions are very hypertonic and must be diluted for use. The osmolarities of the 14.6 and 23.4% concentrations have been calculated to be about 5000 and 8000 mOsm/L, respectively.3860; 3861 The osmolality of the 14.6% concentration was determined to be 5370 mOsm/kg by freezing-point depression and 4783 mOsm/kg by vapor pressure.1071
A 0.9% sodium chloride solution is isotonic, having a calculated osmolarity of 308 mOsm/L.3862 A 0.45% sodium chloride solution is hypotonic, having a calculated osmolarity of 154 mOsm/L.3862
Sodium chloride 3 and 5% solutions are hypertonic, having a calculated osmolarity of 1027 and 1711 mOsm/L, respectively.3863
Sodium chloride additive solutions of 14.6 and 23.4% are administered by intravenous infusion only after dilution in a larger volume of fluid.3860; 3861 Infusion solutions that are hypertonic (e.g., sodium chloride 3 or 5%) should be administered into a large vein.3863
Intact containers of sodium chloride additive solution should be stored at controlled room temperature.3860 Unused portions of single-dose vials should be discarded.3860
The closure of pharmacy bulk packages may be penetrated one time with a suitable sterile dispensing set or transfer device.3861 Pharmacy bulk packages should be discarded within 4 hours of initial entry.3861
Commercially-available sodium chloride infusion solutions (e.g., 0.45, 0.9, 3, 5%) should be stored at room temperature and protected from excessive heat.3862; 3863
Elastomeric Reservoir Pumps
Sodium chloride 0.9% (Baxter) 250 mL was filled into Intermate LV 250 (Baxter) elastomeric infusion devices and stored at 5 and 23°C for 90 days. The solution remained visually compatible with no change in pH and sodium or chloride concentration and less than 0.1% water loss.1993
Standardize 4 Safety
One or more standardized concentrations for this drug have been established through Standardize 4 Safety (S4S), a national patient safety initiative to reduce medication errors, especially during transitions of care. (See Standardize 4 Safety in Users Guide.) Recommendations developed to date through this initiative are available at www.ashp.org/pharmacy-practice/standardize-4-safety-initiative.
Table 1. Standardize 4 Safety Continuous IV Infusion Standard Concentrations for Sodium Chloride3635
| Patient Population | Concentration Standards | Dosing Units |
|---|---|---|
| Pediatric patients (50 kg) | 0.5 mEq/mL (3%) | mL/kg/hour or mEq/kg/hour, depending on institution protocols |
For a list of references cited in the text of this monograph, search the monograph titled References.