Lactated Ringer Side Effects: What Nurses and Patients Should Know
Every year, severe dehydration is one of the leading causes of hospitalization in the US. According to the National Library of Medicine, every 1 to 3% of the hospitalizations in the country are due to dehydration. As a management tool, administering intravenous fluids, including normal saline, lactated Ringer’s solution, and dextrose solution, is the first step. Among these, the use of lactated Ringer’s is preferred for treating dehydration, but, like other IV fluids, it comes with some limitations and risks. Some of these Lactated Ringer Side Effects can be severe and worsen to become life-threatening.
Lactated Ringer’s solution is an essential IV solution in medical settings
In this article, we will learn about the Lactated Ringer Side Effects that should not be ignored while using the product. In addition, some of the well-known intravenous solution brands have also been linked for the reader’s convenience.
What is Lactated Ringer’s Solution?
Lactated Ringer’s (LR) solution, also known as Ringer’s lactate solution (RL), sodium lactate solution, and Hartmann’s solution, is an isotonic solution intended to be administered intravenously. These are sterile and non-pyrogenic, features that make them safe for the patients and reduce the risk of side effects.
The purpose of using the lactated Ringer’s solution is to restore the electrolytes and fluids lost due to dehydration or blood loss associated with a physical injury. In addition, these solutions also find applications in wound flushing and the treatment of metabolic acidosis.
Lactated Ringer Side Effects and Their Management
While using these intravenous solutions, keep in mind that they can, in fact, be associated with certain side effects. In this regard, the following section highlights some of the Lactated Ringer Side Effects:
1. Reactions at the Site of Infusion
Experiencing minor side effects after the administration of intravenous solutions is normal. Similar is the case with the use of lactated Ringer’s solution, which is often associated with the appearance of the following adverse reactions at the site of infusion:
- Pain
- Burning sensation
- Inflammation
- Phlebitis (inflammation of veins near the skin due to blood clotting)
- Rash
- Pruritus or itching sensation
- Erythema (redness of skin or mucus membranes)
2. Hypersensitivity Reaction
Hypersensitivity reaction is a common issue while learning about the possible Lactated Ringer Side Effects. Despite being a safe intravenous solution, some people might be allergic to the components of the products.
Moreover, certain chemicals from the packaging material can also leach into the lactated Ringer’s solution and cause allergies. A common example is that of latex, a known allergen often present in medical products.
These types of Lactated Ringer Side Effects are usually mild but can become severe in some cases. The symptoms in both situations vary, which indicates the severity of the reaction.
Symptoms
The symptoms associated with Lactated Ringer Side Effects caused by hypersensitivity and infusion reactions are as follows, as reported by the Food and Drug Administration (FDA):
Mild Hypersensitivity Reaction
- Rash on the infusion site
- Itching or pruritus
- Localized swelling
Severe Hypersensitivity Reaction
- Chest pain and discomfort
- Angioedema (associated with swelling of face, lips, tongue, or throat that also impacts breathing)
- Bradycardia (decreased heart rate)
- Tachycardia (increased heart rate)
- Respiratory distress
- Decreased blood pressure
- Bronchospasm (associated with constricted airways leading to difficulty in breathing)
- Dyspnea (difficulty in breathing)
- Cough
- Urticaria (appearance of raised, itchy welts on the skin)
- Erythema
- Throat irritation
- Paresthesias (tingling sensation in the skin)
- Hypoesthesia (numbness due to decreased sensitivity to stimulation)
- Dysgeusia (altered taste sensations)
- Nausea
- Pyrexia (fever)
- Headache
- Laryngeal edema (fluid accumulation in the larynx)
- Sneezing
- Infection at the site of injection
Management of Hypersensitivity Reaction
In case of Lactated Ringer Side Effects that indicate a hypersensitivity reaction, the following actions should be taken:
- Stop the infusion immediately as soon as the symptoms start to appear.
- Depending upon the severity of the condition, the administration of epinephrine or antihistamines can help alleviate the symptoms.
Lactated Ringer’s solution acts as a carrier for medication delivery
3. Metabolism and Nutrition Disorders
Another issue which is prominent among the Lactated Ringer Side Effects is the disturbance in the overall metabolism of the body. In such cases, the following may occur:
Hyperkalemia
Hyperkalemia is a state in which the patients have an elevated level of potassium in the body. This is one of the Lactated Ringer Side Effects, which is not commonly encountered as the concentration of potassium in the solution is minimal.
However, patients who already have a condition that elevates the potassium levels in the body are at high risk of hyperkalemia after the administration of lactated Ringer’s solution. These include severe renal impairment, extensive tissue injury or burns, acute dehydration, as well as certain cardiac issues, including congestive heart failure.
Therefore, administration of the solution should be avoided in such patients to avoid Lactated Ringer Side Effects. However, if the use is inevitable, monitoring of the serum potassium levels must be done.
Hyponatremia
Hyponatremia, or a low level of sodium in the body, is one of the possible Lactated Ringer Side Effects. This is because when the lactated Ringer’s solution is used in large volumes, it can cause a dilution of the sodium present in the blood. As a result, a state of hyponatremia becomes inevitable. This hyponatremia can worsen and lead to acute hyponatremic encephalopathy, which is covered in the next section.
Hypervolemia
Hypervolemia or fluid overload occurs as one of the Lactated Ringer Side Effects. The reason behind this is the electrolyte disturbance caused by the administration of lactated Ringer’s solution in large volumes, which often leads to overhydration. As a result, pulmonary congestion and edema occur. In such cases, use of the lactated Ringer’s solution should either be discouraged or, if necessary, the parameters must be monitored thoroughly.
4. Nervous System Disorders
As mentioned above, hyponatremia is one of the Lactated Ringer Side Effects that can further lead to acute hyponatremic encephalopathy. In such a case, the symptoms include the following:
- Nausea
- Headache
- Seizures
- Lethargy
- Vomiting
As the condition is severe, the patient is at a high risk of life-threatening brain injury.
Who is at Risk?
The risk of hyponatremic encephalopathy is particularly higher in patients who are administered with lactated Ringer’s solution despite having a cardiac or pulmonary failure or non-osmotic vasopressin release problems. In addition, pediatric patients, premenopausal women, patients with hypoxemia, or those having an underlying central nervous system disease are also likely to develop this condition after lactated Ringer’s solution administration.
Precautionary Measures/Management of Hyponatremic Encephalopathy
To avoid these Lactated Ringer Side Effects, it is best to avoid the administration of RL solution. However, if the use is necessary, thorough monitoring of the patient’s serum sodium and chloride levels must be done. In addition, fluid status as well as acid-base balance must also be evaluated. Finally, the healthcare providers should also keep track of any symptoms that appear in the patient once the lactated Ringer’s solution is administered.
Healthcare staff administer IV fluids to the patients to ensure replenishment after blood loss
Intravenous Solutions at Health Supply 770: Features and Specifications
Lactated Ringer’s solution is one of the widely used intravenous solutions in medical settings. These solutions are a preferred choice for the treatment of dehydration, blood loss due to trauma, etc., as they can restore the balance of electrolytes and fluids in the body. Being sterile, the solution also does not pose any risk to the patient’s health.
When it comes to learning about Lactated Ringer Side Effects, 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’s injection, USP, is an intravenous solution that is employed for the management of severe dehydration in hospitalized patients. In addition, the product is also ideal for the treatment of metabolic acidosis as it can reverse the condition towards an alkaline state. Furthermore, these ICU Medical lactated Ringer’s injections, USP, can also act as a vehicle to carry and transfer medications into the patient’s bloodstream.
The composition of these ICU Medical lactated Ringer’s injections, USP is simple as these contain solutes dissolved in water, which include sodium chloride, potassium chloride, and calcium chloride in addition to sodium lactate.
Moreover, these ICU Medical lactated Ringer’s injections, USP, come in a flexible plastic bag that can hold up to a volume of 1000 ml or 1 liter. While learning about the Lactated Ringer Side Effects, keep in mind that the packaging contains polyvinyl chloride (PVC) and di(2-ethylhexyl)phthalate (DEHP), which could be an issue in some patients who might be allergic to these components.
B. Braun L7500 Lactated Ringer’s Solution IV 1000 mL CS/12
US$89.88
Product Details
- Braun L7500 lactated Ringer’s solution is a sterile and non-pyrogenic solution that is employed for fluid replenishment in patients who are severely dehydrated or have experienced blood loss due to physical trauma.
Moreover, these B. Braun L7500 lactated Ringer’s solutions contain sodium chloride, potassium chloride, calcium chloride, as well as sodium lactate in water in specified concentrations. In addition, the product is free from any added bacteriostatic or antimicrobial agent that renders the product safe even for people with compromised immune systems.
Furthermore, these B. Braun L7500 lactated Ringer’s solutions can be employed for both pediatric and adult patients. In addition, while learning about the Lactated Ringer Side Effects, the chemical agents in the packaging material are a concern.
In this regard, these B. Braun L7500 lactated Ringer’s solutions come in flexible plastic bags that are free from allergic materials such as PVC or DEHP. Additionally, these also do not contain latex, which is a known allergen often present in medical products.
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 sodium chloride solutions that are administered to replenish the electrolytes and fluids in the body after severe dehydration or blood loss due to physical trauma. In addition, these B. Braun L8000 replacement preparations can also act as a carrier for other medications that are to be administered directly into the bloodstream.
Moreover, these B. Braun L8000 replacement preparations have a sodium chloride concentration of 0.9%. Furthermore, the product does not contain any preservative that makes the preparation safe, as there is minimal risk of hypersensitivity.
Furthermore, these B. Braun L8000 replacement preparations come in packaging that is free from latex, a known allergen that is often added to medical packaging materials.
*Note: The prices of these items mentioned in the article are taken from the Health Supply 770 website. These may vary depending on the vendor.
Intravenous solutions help restore the electrolyte balance of the body
The products mentioned in this article, while learning about the Lactated Ringer Side Effects, 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 is a commonly occurring condition due to less water intake or more sweating, especially during the summer season. Although most cases can be resolved without medical treatment, some patients require hospitalization. In such cases, lactated Ringer’s solution is administered to replenish the lost electrolytes and fluids.
Despite its several benefits, lactated Ringer’s has several prominent side effects. These include minor issues at the site of infusion as well as severe hypersensitivity reactions that could worsen to become life-threatening. Therefore, the administration of the lactated Ringer’s solution should either be avoided in high-risk patients or proper monitoring should be done to avoid complications.
Considering their importance, lactated Ringer’s and other IV solutions should be kept in healthcare facilities to ease 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
