thumb|Intravenous drip of lactated Ringer's
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Ringer's lactate solution (RL), also known as sodium lactate solution, Lactated Ringer's (LR), and Hartmann's solution, is a mixture of sodium chloride, sodium lactate, potassium chloride, and calcium chloride in water. It is used for replacing fluids and electrolytes in those who have low blood volume or low blood pressure.
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Side effects may include allergic reactions, high blood potassium, hypervolemia, and high blood calcium. It is isotonic, i.e. it has the same tonicity as blood. It is on the World Health Organization's List of Essential Medicines. Lactated Ringer's is available as a generic medication. In Scandinavia, Ringer's acetate is typically used.
Medical uses
Ringer's lactate solution is commonly used for fluid resuscitation after blood loss due to trauma or surgery.
It is extensively used in aggressive volume resuscitation, e.g. for patients with pancreatitis, hemorrhagic shock or major burn injuries. In acidotic states, such as in acute kidney failure, Ringer's lactate solution may be advantageous as the byproducts of lactate metabolism in the liver counteract the acidosis.
- 130–131 mEq of sodium ion = 130 mmol L<sup>−1</sup>
- 109–111 mEq of chloride ion = 109 mmol L<sup>−1</sup>
- 28–29 mEq of lactate ion = 28 mmol L<sup>−1</sup>
- 4–5 mEq of potassium ion = 4 mmol L<sup>−1</sup>
- 2–3 mEq of calcium ion = 1.5 mmol L<sup>−1</sup>
Ringer's lactate has an osmolarity of 273 mOsm L<sup>−1</sup>
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. Ringers lactate should not cause an elevated blood-lactate level except possibly in the most severe presentations of liver failure.
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.
See also
- Banana bag
- Intravenous therapy
- Oral rehydration therapy
- Phosphate buffered saline (cell culture)
- Tyrode's solution