...Ringer Lactate solution has slow alkalinising effect provided the liver is functioning normally, otherwise Ringer Acetate is used. In the liver, Lactate is converted to glucose through Cori Cycle and Bicarbonate is produced as a by-product, which has the alkalinising effect, although RL has pH 6.5.
...for acute loss (20-30 ml/Kg/hr) and for intraoperative use, Ringer Lactate (RL) is better. But, for maintenance mix of Normal Saline (NS) or Dextrose Saline with Ringer Lactate is better. Generally, in an adult - 2 bottles of NS, 2 bottles of RL and 1 bottle of Dextrose = 2.5 L/day @ 100 ml/hr suffices.
...RL contains ions of sodium 131 mEq/L, potassium 5 mEq/L, calcium 2 mEq/L, chloride 111 mEq/L, and lactate 29 mEq/L. RL has an osmolarity of 273 mOsmol/L, pH of 6.5, and caloric content of 9 kcal/L. It has fluid and electrolyte balancing effect besides the slow alkalinising effect.
...RL should not be mixed with ceftriaxone due to the significant risk of precipitation with calcium content of RL. Also, RL should not be mixed with stored blood because the calcium cause clot formation - calcium chelating effect of the anticoagulant becomes inffective.
...RL is isotonic with blood and most physiologic crystalloid, which was formulated by Alexis Hartmann (1930) by addition of Sodium Lactate to Ringer's Solution (Sydney Ringer 1880). Ringer's solution is used in Physiology lab for preservation of frog's beating heart, gastrocnemius muscle etc.
...though RL is useful for resuscitation, it is not suitable for maintenance because it has lower Na content (131 mEq/L; serum Na 135-155 mEq/L) and K = 5 mEq/L (serum 3.5 -5.5 mEq/L) is also too low in view of daily requirement (3.0-4.7 gm/day; 750 mg = 10 mEq Kcl; normally 40-50 mEq/day). Moreover, long term use can cause alkalosis by its slow alkalinising effect. In order to maintain electrical neutrality, Na in RL is kept lower at 131 mEq/L than in blood (135-155 mEq/L).
Ringer's lactate solution:
https://en.m.wikipedia.org/wiki/Ringer%27s_lactate_solution
Lactated Ringer's Solution:
https://www.medicinenet.com/ringers-lactated_ringers_solution-intravenous/article.htm
Ringer's solution:
https://en.m.wikipedia.org/wiki/Ringer%27s_solution
How Much Potassium Do You Need Per Day?
https://www.healthline.com/nutrition/how-much-potassium-per-day
Potassium Supplement (Oral Route, Parenteral Route): https://www.mayoclinic.org/drugs-supplements/potassium-supplement-oral-route-parenteral-route/description/drg-20070753
...for acute loss (20-30 ml/Kg/hr) and for intraoperative use, Ringer Lactate (RL) is better. But, for maintenance mix of Normal Saline (NS) or Dextrose Saline with Ringer Lactate is better. Generally, in an adult - 2 bottles of NS, 2 bottles of RL and 1 bottle of Dextrose = 2.5 L/day @ 100 ml/hr suffices.
...RL contains ions of sodium 131 mEq/L, potassium 5 mEq/L, calcium 2 mEq/L, chloride 111 mEq/L, and lactate 29 mEq/L. RL has an osmolarity of 273 mOsmol/L, pH of 6.5, and caloric content of 9 kcal/L. It has fluid and electrolyte balancing effect besides the slow alkalinising effect.
...RL should not be mixed with ceftriaxone due to the significant risk of precipitation with calcium content of RL. Also, RL should not be mixed with stored blood because the calcium cause clot formation - calcium chelating effect of the anticoagulant becomes inffective.
...RL is isotonic with blood and most physiologic crystalloid, which was formulated by Alexis Hartmann (1930) by addition of Sodium Lactate to Ringer's Solution (Sydney Ringer 1880). Ringer's solution is used in Physiology lab for preservation of frog's beating heart, gastrocnemius muscle etc.
...though RL is useful for resuscitation, it is not suitable for maintenance because it has lower Na content (131 mEq/L; serum Na 135-155 mEq/L) and K = 5 mEq/L (serum 3.5 -5.5 mEq/L) is also too low in view of daily requirement (3.0-4.7 gm/day; 750 mg = 10 mEq Kcl; normally 40-50 mEq/day). Moreover, long term use can cause alkalosis by its slow alkalinising effect. In order to maintain electrical neutrality, Na in RL is kept lower at 131 mEq/L than in blood (135-155 mEq/L).
Ringer's lactate solution:
https://en.m.wikipedia.org/wiki/Ringer%27s_lactate_solution
Lactated Ringer's Solution:
https://www.medicinenet.com/ringers-lactated_ringers_solution-intravenous/article.htm
Ringer's solution:
https://en.m.wikipedia.org/wiki/Ringer%27s_solution
How Much Potassium Do You Need Per Day?
https://www.healthline.com/nutrition/how-much-potassium-per-day
Potassium Supplement (Oral Route, Parenteral Route): https://www.mayoclinic.org/drugs-supplements/potassium-supplement-oral-route-parenteral-route/description/drg-20070753
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