What Are Lactated Ringers

Lactated Ringer Solution, sometimes called Lactated Ringer’s or simply LR in the hospital, is a type of intravenous, or IV, fluid. Choosing an IV fluid for administration requires consideration of the type of fluid as well as the patient’s particular diagnosis. Since Lactated Ringer’s intravenous fluid qualifies as a medication, a physician must prescribe its use.

A doctor adjusts an IV drip filled with Lactated Ringer's Solution. (Image: Comstock Images/Stockbyte/Getty Images)

Composition

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 cell functioning, such as sodium, chloride, potassium and calcium, but not in the same proportion as the human body. The lactate in the solution has an alkalizing effect, DailyMed states. Lactated Ringer’s is sometimes combined with 5 percent dextrose fluid in a solution called D5LR.

Method of Administration

Intravenous access into a vein must be obtained to administer Lactated Ringer’s. A plastic catheter inserted using a sterile technique into the vein provides short-term access for fluid administration. Careful attention must be paid to the IV site to watch for signs of infection at the insertion site that could spread to the bloodstream.

Uses

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.

Risks

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, Elizabeth Criss, R.N. of the University of Arizona reports. 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.

Since the solution also contains electrolytes, careful consideration should be given to the effect this fluid might have on electrolyte levels in the body. Allergic reactions such as rash, fever, hives, swelling of the face, difficulty breathing, itching, coughing and sneezing can occur during administration, MIMS warns.

Contraindications

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, DailyMed warns.

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, according to MIMS.

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