Lactated Ringer's solution is an electrolyte solution primarily used in clinical treatment to replenish fluids and electrolyte balance. Its components include sodium chloride, potassium chloride, calcium chloride, and sodium lactate, which provide the necessary sodium, potassium, and calcium ions for the human body. It is slowly metabolized to produce bicarbonate to regulate blood pH. The composition of this solution closely resembles extracellular fluid, making it widely used in situations requiring rapid fluid replacement such as surgery, trauma, or severe dehydration.
This medication is administered via intravenous infusion and must be operated by healthcare professionals within medical institutions. Its core functions are to maintain fluid volume, electrolyte stability, and acid-base balance, especially effective for fluid deficits caused by heavy sweating, bleeding, or gastrointestinal losses.
The scientific name of this medication is “Lactated Ringer's Solution.” Common commercial names in Taiwan, Hong Kong, and the international market include:
Lactated Ringer's solution is classified as an “Electrolyte Replacement Solution” and an “Intravenous Fluid,” and is a prescription medication. It is also regarded as a “Volume Expander” used to treat circulatory instability caused by fluid loss.
Main indications and diseases:
This medication can also be used in conjunction with other treatments, such as fluid balance adjustment after chemotherapy, or as a carrier solution for infusing other drugs.
Mild side effects:
Severe side effects requiring immediate discontinuation:
Contraindications:
Pregnancy and Lactation: Pregnant women may use if necessary, but blood lactate levels should be monitored. Lactating women should use after medical evaluation; there is currently no evidence of effects through breast milk on the infant.
Use with diuretics (such as furosemide) may exacerbate electrolyte imbalance, requiring adjustment of infusion rate. When used with anticoagulants (such as warfarin), calcium ions in the solution may reduce anticoagulant efficacy.
Avoid mixing with calcium-containing antibiotics (such as vancomycin) to prevent precipitation. When using digoxin, monitor blood sodium and potassium levels to prevent toxicity.
The dosage depends on the patient's weight, age, and severity of illness. The common initial adult dose is 100-200 cc per hour, with pediatric doses calculated based on weight. Infusion is administered via venipuncture or central venous catheter, with the rate adjusted dynamically by healthcare staff based on blood pressure and urine output.
Do not adjust the infusion rate or concentration by yourself. Infusing too quickly may cause pulmonary edema, while too slow may not effectively improve dehydration. Special populations (such as the elderly or cardiac patients) should have reduced initial infusion rates.
This medication must be administered within a medical facility. If a scheduled infusion is missed, notify healthcare personnel immediately to reschedule. In case of delay due to emergency, medical staff will reassess the infusion plan based on current blood pressure and laboratory data.
Over-infusion may lead to hypernatremia or metabolic alkalosis, with symptoms such as tremors, altered consciousness, or muscle weakness. Infusion should be stopped immediately, and dialysis or buffering solutions should be administered for neutralization.
If cardiac arrest or other emergencies occur, CPR should be performed and electrolyte levels monitored. Do not attempt to treat by yourself; seek immediate medical attention.
The infusion rate should be adjusted based on the patient's age, weight, and severity of illness. Too rapid infusion can overload the heart, especially in patients with cardiac or renal impairment, potentially causing pulmonary edema or blood pressure abnormalities. Healthcare providers monitor vital signs (such as heart rate and blood pressure) to regulate an appropriate rate.
What symptoms might indicate electrolyte imbalance during Lactated Ringer's use?If muscle weakness, cramps, palpitations, or unexplained vomiting occur, these may be signs of abnormal sodium or potassium levels. For long-term use or when combined with diuretics, blood tests are regularly performed to monitor electrolytes and renal function to ensure safety.
What should be noted when combining Lactated Ringer's with antibiotics or analgesics?Some antibiotics (such as aminoglycosides) may interact with sodium ions in Lactated Ringer's, increasing nephrotoxicity risk. Inform healthcare providers of all medications being taken and follow their instructions for dose adjustments or monitoring.
Are there dietary restrictions for patients receiving Lactated Ringer's?If patients have hypercalcemia or hyperkalemia, they should avoid excessive intake of dairy products or high-potassium foods (such as bananas, spinach). Doctors may recommend a low-sodium diet to prevent electrolyte imbalance and reduce renal metabolic burden.
When should Lactated Ringer's be discontinued immediately?If symptoms such as difficulty breathing, severe edema, altered consciousness, or markedly decreased urine output occur, it may indicate an allergic reaction or acute renal failure. Immediate medical evaluation and intervention, such as dialysis, are necessary.
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