calcium chloride dihydrate + glucose monohydrate + magnesium chloride hexahydrate + sodium chloride + sodium hydrogen carbonate: clinical use

Prescribing considerations

• Use under the direction of a clinician experienced in continuous haemofiltration.
• Account for total fluid balance, concurrent infusions, residual renal function and metabolic state.
• Because the formulation is potassium-free, select it only where compatible with current and anticipated potassium requirements.
• Replace the solution and tubing immediately if precipitation appears.
• Do not add another medicinal product unless compatibility has been fully evaluated after mixing.

Contraindications and cautions

• Hypokalaemia.
• Metabolic alkalosis.
• Marked hypercatabolic acute renal failure when uraemic symptoms cannot be adequately corrected by haemofiltration.
• Inadequate vascular-access blood flow.
• States in which systemic anticoagulation creates an increased haemorrhage risk.

Monitoring

• Haemodynamic status and overall fluid balance.
• Potassium, calcium, magnesium, sodium, phosphate and other relevant electrolytes.
• Acid–base status and bicarbonate effect.
• Blood glucose, urea and plasma creatinine.
• Circuit clarity and tubing for delayed calcium carbonate precipitation.

Clinical pharmacology

Continuous ultrafiltration removes water and filterable solutes from blood. This bicarbonate-buffered solution restores fluid and physiological ions to support blood volume, osmotic equilibrium and acid–base balance.

Formulation and product differences

• This product is potassium-free, unlike Duosol formulations containing potassium.
• Separate electrolyte and bicarbonate chambers must be completely mixed before use.
• After mixing, it is a clear, colourless bicarbonate-buffered haemofiltration solution containing glucose but no potassium.