RINGER LACTATE

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    Last updated: November 2023

     

    Indications

    • Severe dehydration
    • Fluid replacement in trauma, surgery, anaesthesia)

    Forms and strengths

    • 500 ml and 1000 ml bottles or bags

    Composition

    • Varies with manufacturer.
    • Most frequent ionic composition per litre:

    sodium (Na+)      130.50 mmol    (130.50 mEq)

    potassium (K+)       4.02 mmol    (4.02 mEq)

    calcium (Ca++)        0.67 mmol    (1.35 mEq)

    chloride (Cl–)      109.60 mmol    (109.60 mEq)

    lactate                  28.00 mmol    (28.00 mEq)

    • Isotonic solution. Does not contain glucose. 

     

    Ringer Lactate provides appropriate amounts of sodium and calcium and 4 mEq of potassium/litre, which is sufficient for short-term use. It contains lactate which is converted to bicarbonate for correction of metabolic acidosis when it exists (if haemodynamic and liver function are normal). Warning, some commercially available solutions do not contain lactate.

    Contra-indications, adverse effects, precautions

    • In cases of metabolic alkalosis, diabetes, severe renal or hepatic failure, hyperkalemia, head injury: isotonic solution of NaCl 0.9% is preferred.

    Remarks

    • After infusion, Ringer lactate remains in the intravascular compartment for 1 to 2 hours.
    • For correction of hypovolaemia due to haemorrhage; administer 3 times the lost volume only if:
      • blood loss does not exceed 1500 ml in adults;
      • cardiac and renal function are not impaired.
    • Ringer lactate may also be used to prevent hypotension induced by spinal anaesthesia.
    • Also comes in a premixed solution of 5% glucose/Ringer lactate, which is the preferred infusion solution for maintenance fluids in children.
    • For moderate and mild dehydration, administer oral rehydration salts (ORS).

    Storage

    Below 25 °C

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