RINGER LACTATE



Indications

– Severe dehydration
– Hypovolaemia (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. 

Contra-indications, adverse effects, precautions

– In cases of metabolic alkalosis, diabetes, severe hepatic failure, head injury: isotonic solution of NaCl 0.9% is preferred.
– Ringer Lactate provides appropriate amounts of sodium and calcium. 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.
– It contains 4 mEq of potassium/litre, which is sufficient for short-term use. For prolonged use (after 2 to 3 days), addition of potassium chloride is necessary: 1 or 2 g per litre = one to two 10 ml ampoules of KCL 10%/litre.
– For moderate and mild dehydration, administer oral rehydration salts (ORS).

Remarks

– 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.
– May be used to prevent hypotension induced by spinal anaesthesia.
Storage: below 25 °C