Lactated Ringer Injection: Uses, Dosage, and Administration
Metabolic acidosis is a state associated with too much acid in the body fluids. This is common in patients with chronic kidney disease (CKD). If left untreated, metabolic acidosis can become life-threatening. One of the management strategies is to administer Lactated Ringer Injection due to its alkalinizing nature. Apart from this, Lactated Ringer Injections can also be used to achieve various benefits.
Intravenous solutions help manage severe dehydration by replenishing the lost electrolytes
In this article, we will learn about the Lactated Ringer Injections in terms of their usage, dose, and method of administration. In addition, some of the well-known intravenous solution brands have also been linked for the reader’s convenience.
What is Lactated Ringer Injection?
Lactated Ringer’s (LR) injection, also known as Ringer’s lactate solution (RL), Hartmann’s solution, or sodium lactate solution, is a sterile and non-pyrogenic intravenous solution intended to treat electrolyte imbalance and dehydration.
As these solutions are isotonic, they match the body’s normal tonicity. As a result, they do not disturb the cellular structures. Lactated Ringer Injection is the solution of choice when the patient is in a state of metabolic acidosis, as the solution can transform this into an alkaline state. Moreover, Lactated Ringer Injection can also be used to flush the wounds.
Composition
Lactated Ringer Injection has the following salts dissolved in water to make a clear, isotonic solution. The concentrations of the salts given in the table are for 1 liter or 1000 ml of solution and are modified according to the volume of the solution. These Lactated Ringer Injections are available in 250, 500, and 1000 ml packaging.
| Lactated Ringer’s Ingredients | Formulae | Concentration (g/L) |
| Sodium chloride | NaCl | 6.00 g |
| Potassium chloride | KCl | 0.30 g |
| Calcium chloride, dihydrate | CaCl2.2H2O | 0.20 g |
| Sodium lactate | C3H5NaO3 | 3.10 g |
The above-mentioned concentrations have been reported by the Food and Drug Administration (FDA). As for the milliequivalents of the ionic species of the lactated Ringer’s solution, the following table enlists the values:
| Ingredients of Lactated Ringer Injection | Ionic Species | Milliequivalents (mEq) |
| Sodium | Na+ | 130 |
| Potassium | K+ | 4 |
| Calcium | Ca2+ | 3 |
| Chloride | Cl– | 109 |
| Lactate | CH3CH(OH)COO– | 28 |
Uses
The Lactated Ringer Injections are employed for the management of the following conditions:
Treatment of Dehydration
As the Lactated Ringer Injection contains salts that are essential for the body, it can act as an electrolyte and fluid replenisher in case of severe dehydration. These salts include sodium chloride, potassium chloride, and calcium chloride dissolved in water, along with sodium lactate.
Management of Metabolic Acidosis
Lactated Ringer Injection is also employed for the management of metabolic acidosis. The sodium lactate present in the solution ionizes to give lactate ions. These are further metabolized by the liver to form water and carbon dioxide, which further form bicarbonate ions.
Once the bicarbonate is formed, excess acid is neutralized, and the pH of the body is raised. Resultantly, the acidosis shifts into a state of alkalosis.
Wound Irrigation
Another application of Lactated Ringer Injection is that it is used for flushing wounds and the surgical sites. As a result, the blood, debris, and bacteria present at the site are effectively removed.
Intravenous solutions also help regain lost fluids after a traumatic injury
Dosage
While choosing a dose, rate, volume, and duration of administration of the Lactated Ringer Injection, the age, body weight, and clinical condition of the patient must be taken into consideration.
In addition, if the patient is on concomitant therapy, this also needs to be kept in mind. Therefore, this information should be provided to a physician with expertise in intravenous fluid therapy to get a calculated dose of the Lactated Ringer Injection.
Apart from this, it is also essential to consult with a pharmacist regarding the additives present in the product, as some of these may be incompatible with the medications being given to the patient. Also, focus should be given on the chemical nature of the plastic containers that carry the Lactated Ringer Injections.
Addition of Additives
If the addition of additives in the Lactated Ringer Injection is necessary, it is advised to mix them in the solution using aseptic technique. Once the additives have been introduced into the solution, mix them well until a clear solution is obtained.
In case of the appearance of color or any precipitate in the solution, do not use it. Similar practice should be adopted if the solution forms crystals or insoluble salts.
Never store the solution containing additives and use it immediately after formulating. Discard any portion of the solution that remains after administration.
Administration Instructions
When it comes to administering the Lactated Ringer Injection, keep in mind the following instructions given by the FDA to get maximum benefit from the product:
- As the Lactated Ringer Injection is sterile, it should only be administered intravenously using sterile equipment.
- Before administering the injection, inspect the solution with the naked eye. The presence of any particulate matter or any discoloration indicates non-sterility. In such a case, the solution should be discarded. Keep in mind that Lactated Ringer Injection should only be administered if it is clear and comes in a container that is undamaged.
- To minimize the risk of air embolism, either use a non-vented infusion set or use a vented set with its vent closed.
- A single dedicated infusion line should be preferred over one with connections. This can reduce the risk of infections by ensuring that the solution remains sterile until administration.
- It is not recommended to use pressure infusion for the administration of Lactated Ringer Injection to increase flow rates. However, if it is necessary, make sure that the air in the bag is fully evacuated before starting the infusion.
- In case of using a pumping device, the pump should be turned off before the container is empty.
- Avoid administering Lactated Ringer Injection and citrate anticoagulated/preserved blood through the same infusion line, as there is a risk of coagulation due to the calcium content present in the Lactated Ringer Injection.
Overdose of Lactated Ringer Injection
In case of an overdose of Lactated Ringer Injection, the risk of the following increases:
- Fluid overload that leads to pulmonary and/or peripheral edema
- Hyperkalemia (elevated levels of potassium in the body)
- Hyperkalemia (elevated levels of potassium in the body), especially in patients with severe renal impairment
- Hypernatremia (elevated levels of sodium in the body), especially in patients with severe renal impairment
- Metabolic alkalosis with or without hyperkalemia
- Loss of bicarbonate ions with an acidifying effect
Lactated Ringer’s solution can carry and transfer medications to the body
Intravenous Solutions at Health Supply 770: Features and Specifications
Lactated Ringer’s solutions are effective for the management of severe dehydration and metabolic acidosis. These are sterile solutions that are safe due to their non-pyrogenic nature. In addition, these solutions also help restore the lost electrolytes and fluid balance as they are rich in the necessary salts required for our body.
When it comes to learning about Lactated Ringer Injections, it is also essential to look into some of the products that many brands manufacture. Some of these well-known brands are also available at Health Supply 770 and have been detailed below, along with their features and purchase links:
ICU Medical Lactated Ringer’s Injection, USP, 1000 mL (12/Cs)
Product Details
ICU Medical Lactated Ringer Injection, USP, is a sterile and non-pyrogenic solution that is administered intravenously to treat severe dehydration and metabolic acidosis. This is because the product contains sodium chloride, potassium chloride, and calcium chloride in addition to sodium lactate dissolved in water.
The chloride salts are effective for replenishing the electrolytes and fluids lost due to dehydration or blood loss. In addition, the lactate ions reverse the metabolic acidosis. Moreover, these ICU Medical Lactated Ringer Injections, USP, can also be used as a carrier for medications that are to be directly delivered into the bloodstream.
Furthermore, these ICU Medical Lactated Ringer Injections, USP, are packed in a flexible plastic bag that can hold up to 1000 ml of the solution. However, polyvinyl chloride (PVC) and di(2-ethylhexyl)phthalate (DEHP) present in the solution may cause allergies in some patients who have a known hypersensitivity to these chemical substances.
B. Braun L7500 Lactated Ringer’s Solution IV 1000 mL CS/12
US$89.88
Product Details
Braun L7500 lactated Ringer’s solutions are non-pyrogenic and sterile solutions that are ideal for the treatment of severe dehydration and loss of blood due to a traumatic injury. In addition, the solution can also be employed for flushing the wounds to clear out blood, debris, and microbes.
As for their composition, these B. Braun L7500 lactated Ringer’s solutions contain sodium chloride, potassium chloride, and calcium chloride dissolved in water in specified concentrations to achieve a clear solution. In addition, sodium lactate is incorporated, which acts as an alkalinizing agent.
Moreover, these B. Braun L7500 lactated Ringer’s solutions do not contain any preservatives, as well as bacteriostatic or antimicrobial agents. This way, the solution becomes safe for the patients with a weak immune system.
Furthermore, these B. Braun L7500 lactated Ringer’s solutions come in flexible packaging that is free from PVC or DEHP, which can leach into the solution and cause allergies to the patient when infused. In addition, the product is also free from latex. These B. Braun L7500 lactated Ringer’s solutions are suitable for use in both pediatric and adult patients.
B. Braun L8000 Replacement Preparation Sodium Chloride, Preservative Free 0.9% IV Solution Flexible Bag 1,000 mL 12 EA/CA
US$99.88
Product Details
Braun L8000 replacement preparations are the intravenous solutions that contain sodium chloride as their chief electrolyte. The solution is prepared by dissolving 9 grams of salt into water that is made up to a 1-liter volume. This gives a concentration of 0.9%. Once prepared, the solution is packed in flexible plastic bags that are free from latex, a known allergen often found in medical products.
Moreover, these B. Braun L8000 replacement preparations do not contain any preservatives. This way, the solution becomes safe for people who might have a hypersensitivity reaction to certain additives.
As for their use, these B. Braun L8000 replacement preparations are employed to manage dehydration. In addition, they can also balance lost fluids from the body after a traumatic injury. B. Braun L8000 replacement preparations are also suitable for carrying medications that can then be directly administered into the patient’s bloodstream.
*Note: The prices of these items mentioned in the article are taken from the Health Supply 770 website. These may vary over time.
Intravenous infusions are necessary for all hospitalized patients
The products mentioned in this article, while learning about the Lactated Ringer Injections, along with many other medical supplies, can be purchased from Health Supply 770, a reliable name when it comes to medical products. They have a 30-day money-back guarantee and provide your products to you in the shortest possible time. Click the link at the end of the article to check the wide range of IV solutions.
Conclusion
Dehydration and metabolic acidosis are conditions that often require proper treatment so that these conditions can be contained before they become life-threatening. In both of these cases, administering lactated Ringer’s solution is one of the management strategies. This is because the chloride salts of sodium, potassium, and calcium present in the solution help regain the lost electrolyte and fluid balance.
In case of metabolic acidosis, the lactate ions present in the solution generate bicarbonate ions upon metabolism, which reduce the overall pH of the body. As a result, the acidic state is neutralized. The dose of the lactated Ringer’s solution has to be decided depending on the patient’s condition, age, and weight.
Considering their importance, Lactated Ringer Injections and other IV solutions should be kept in healthcare facilities to ease the medical procedures. For purchasing different types of intravenous solutions, reliable vendors like Health Supply 770 should be approached. They ensure the provision of quality products along with satisfactory services.
References
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/016682s117lbl.pdf
