Totilac

Totilac is a hypertonic sodium lactate solution (containing 500 mEq/L of sodium lactate) designed for fluid resuscitation and the management of intracranial hypertension. It is primarily utilized in neuro-critical care to reduce cerebral edema in patients with traumatic brain injury or stroke. The solution's high osmolarity creates an osmotic gradient that shifts fluid from the intracellular and interstitial spaces of the brain into the intravascular compartment. Beyond its osmotic effects, the lactate component is metabolized into bicarbonate, providing a buffering effect against metabolic acidosis, and serves as an alternative oxidative fuel for neurons during periods of metabolic stress. Totilac is manufactured by Otsuka Indonesia and is often compared to other hyperosmolar therapies like mannitol and hypertonic saline, offering potential advantages in terms of hemodynamic stability and brain metabolism.

Brand names

Totilac

Other names

Hypertonic sodium lactate solution