Ringer's lactate solution

Ringer's lactate solution

A bottle of Ringer's lactate solution
Clinical data
Other names	compound sodium lactate, sodium lactate solution, Hartmann's solution, Ringer-Locke's solution, Ringer-lactate, lactated Ringer's solution (LRS)
AHFS/Drugs.com	FDA Professional Drug Information
License data	US DailyMed: Ringers
Routes of administration	intravenous, topical, subcutaneous
ATC code	B05BB01 (WHO)

Ringer's lactate solution (RL), also known as sodium lactate solution, Lactated Ringer's, and Hartmann's solution, is a mixture of

Ringer's solution was invented in the 1880s; lactate was added in the 1930s.^[4] It is on the World Health Organization's List of Essential Medicines.^[6] Lactated Ringer's is available as a generic medication.^[1] For people with liver dysfunction, Ringer's acetate may be a better alternative with the lactate replaced by acetate.^[7] In Scandinavia Ringer's acetate is typically used.^[8]

Medical uses

Ringer's lactate solution is commonly used for

Ringer's lactate and other crystalloid fluids are also used as vehicles for the intravenous (IV) delivery of medications.[10]

Chemistry

One liter of Ringer's lactate solution contains:^[13]

• 130–131
  mmol L⁻¹
• 109–111 mEq of chloride ion = 109 mmol L⁻¹
• 28–29 mEq of lactate ion = 28 mmol L⁻¹
• 4–5 mEq of potassium ion = 4 mmol L⁻¹
• 2–3 mEq of calcium ion = 1.5 mmol L⁻¹

Ringer's lactate has an

The solution is formulated to have concentrations of potassium and calcium that are similar to the ionized concentrations found in normal blood plasma. To maintain electrical neutrality, the solution has a lower level of sodium than that found in blood plasma or normal saline.[4]

Generally, the source of the constituent ions is a mixture of sodium chloride (NaCl), sodium lactate (CH₃CH(OH)CO₂Na), calcium chloride (CaCl₂), and potassium chloride (KCl), dissolved into distilled water. Ringer's solution has the same constituents without the sodium lactate, though sometimes it may also include magnesium chloride (MgCl₂).^[16][17]

There are slight variations for the composition for Ringer's as supplied by different manufacturers. As such, the term Ringer's lactate should not be equated with one precise formulation.^[18]

History

Ringer's saline solution was invented in the early 1880s by

Ringer's solution technically refers only to the saline component, without lactate. Some countries instead use a Ringer's acetate solution or Ringer-acetate, which has similar properties. This was thought to be helpful when analyzing blood-lactate for signs of anaerobic metabolism (e.g. present with septic shock, hypovolemic shock). Subsequently, it has been shown that lactate is metabolized much faster than infused.^[21] Ringers lactate should not cause an elevated blood-lactate level except possibly in the most severe presentations of liver failure.^{[citation needed]}

Veterinary use

It is used for the treatment or palliative care of chronic kidney failure in small animals. The solution can be administered intravenously or subcutaneously. Administering the fluids subcutaneously allows the solution to be readily given to the animal by a trained layperson, as it is not required that a vein be located. The solution is slowly absorbed from beneath the skin into the bloodstream of the animal.^[22]

See also

• Intravenous therapy
• Oral rehydration therapy
• Phosphate buffered saline
  (cell culture)
• Tyrode's solution

References