Lactated Ringer’s classified as an isotonic or crystalloid solution, has similar osmolarity to body fluids, meaning that it maintains fluid volumes in balance between the space inside and outside the blood vessels. Lactated Ringer’s contains electrolytes, substances necessary for cells to function. It’s intended for intravenous administration, but if a suitable vein cannot be found it can be given orally which has an unpleasant taste. It is made up of NaCl (sodium chloride), NaC3H5O3 (sodium lactate), CaCl2 (Calcuim Chloride), and KCl (potassium Chloride). Lactated Ringer’s has a pH of 6.5, but is an alkalizing solution. Therapy
Lactated Ringer’s solution is used to induce urine output in patients with renal failure, and to supply water and electrolytes either with or without calories to the body. It is also used because the by-products of lactate metabolism in the liver counteract acidosis which is a chemical imbalance that occurs with acute fluid loss or renal failure. Lactated Ringer’s is used when intravascular volume is low or to maintain fluid volume during surgery or labor, dehydration, burns, gastrointestinal fluid loss, and acute blood loss may all dictate Lactated Ringer’s administration to replace large fluid losses quickly. Dose
The I.V. Dose of Lactated Ringer’s solution is calculated by estimated fluid loss and presumed fluid deficit. The usual administration rate is 20 to 30 ml/kg body weight/ hour. Lactated Ringer’s solution is not suitable for maintenance because sodium content is considered too high, particularly in children, and the potassium content is to low in view of electrolyte daily requirements. Side Effects and Risk
The most common side effects are redness and pain around the injection site. Allergic reactions such as rash, fever, hives, swelling of the face, difficulty breathing, itching, coughing and sneezing can occur during administration. Like any intravenous fluid, Lactated Ringer’s can cause fluid overload, since only 25 percent of administered fluid stays in the vascular system while the rest travels into the tissues. In serious fluid loss, this means large volumes of fluid must be given. Cerebral edema can increase in patients with head injury after Lactated Ringer’s infusion. Reasons not to take Lactated Ringer’s
Lactated Ringer’s should not be given to patients with kidney failure, because it contains potassium and may lead to hyperkalemia, or high potassium levels. Lactated Ringer’s should not be used in people with liver disease, because they can’t break down the lactate in the solution. People with lactic acidosis or alkalosis should also not be given Lactated Ringer’s, which can change the electrolyte balance in the body. Patients with congestive heart failure and edema due to sodium overload should also not receive Lactated Ringer’s, which may increase edema. Lactated Ringer’s should not be given during administration of blood or blood products, because blood may coagulate.