Fluid therapy with l-lactate and/or pyruvate anions

Abstract

Electrolyte solutions are provided which are useful in electrolyte and fluid therapy, parenteral nutrition and dialysis. The Na:Cl ratio is normalized, plasma and cellular pH are normalized and cellular cofactor ratios are normalized in a manner which decreases toxicity over prior art solutions.

Description

BACKGROUND OF THE INVENTION 1. Field of the Invention This invention lies in the field of fluid therapy in humans, and more particularly in the field of aqueous solutions for parenteral, oral, dialysis, and irrigation therapy which employ at least one of 1-lactate anions, pyruvate anions, d-betahydroxybutyrate anions, acetoacetate anions, or mixtures thereof in combination with selected cations. 2. Prior Art Previously, I have provided improved electrolyte solutions for in vivo and in vitro usage which contain 1-lactate and pyruvate anions, and / or d-betahydroxybutyrate and acetoacetate anions in respective defined ratios in combination with defined Na:Cl ratios; see my copending U.S. patent applications Serial Nos. 748,232 and 747,792, both filed Jun. 24, 1985, and also my copending U.S. patent application Serial Nos. 747,858 and 748,184, also filed on such date. However, it is now appreciated that the benefits of using 1-lactate, pyruvate, d-betahydroxybutyrate, and / or acetoace...

AI Technical Summary

Benefits of technology

More particularly, this invention is directed to improved methods and optionally stable fluids for conventional administration to humans such as, (a) oral ingestion of an aqueous solution containing at least one of such anions, or a mixture of such anions, (b) parenteral therapy involving, for example, the intravenous administration of an aqueous solution containing at least one of such anions, or a mixture thereof, (c) dialysis therapy (hemo or peritoneal) using aqueous solutions containing at least one of such anions, (d) dialysis therapy (hemo or peritoneal) where acetic acid is replaced with at least one acid of the group consisting of 1-lactate, pyruvate, d-betahydroxybutyrate or acetoacetic acid, preferably 1-lactate, and / or (e) irrigation therapy.

One presently preferred such anion comprises 1-lactate. Thus, surprisingly, encephalopathy, metabolic bone disease, and many other complications are not only completely avoided by using 1-lactate (or one of the other metabolite anions herein identified and used in the practice of this invention) in place of racemic d-1-lactate, but also the substitution of, for example, 1-lactate for d-1-lactate, in solutions employed in fluid therapy, does not cause any change in the heretofore known beneficial physiological or pharmacological effectiveness of such fluids.

Problems solved by technology

Thus, the d- form has now been discovered to cause adverse and toxic effects when administered to mammals.

With continued administration, coma develops, the cerebral edema worsens and death ensues.

Thirdly, it is used as the counter ion in peritoneal dialysis solutions.

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