Hartmann's solution

Ringer's lactate solution (RL), also known as sodium lactate solution and Hartmann's solution, is a mixture of sodium chloride, sodium lactate, potassium chloride, and calcium chloride in water. It is used for replacing fluids and electrolytes in those who have low blood volume or low blood pressure. It may also be used to treat metabolic acidosis and to wash the eye following a chemical burn. It is given by injection into a vein or applied to the affected area. Ringer's lactate solution (RL), also known as sodium lactate solution and Hartmann's solution, is a mixture of sodium chloride, sodium lactate, potassium chloride, and calcium chloride in water. It is used for replacing fluids and electrolytes in those who have low blood volume or low blood pressure. It may also be used to treat metabolic acidosis and to wash the eye following a chemical burn. It is given by injection into a vein or applied to the affected area. Side effects may include allergic reactions, high blood potassium, volume overload, and high blood calcium. It may not be suitable for mixing with certain medications and some recommend against use in the same infusion as a blood transfusion. Ringer's lactate solution has a lower rate of acidosis as compared with normal saline. Use is generally safe in pregnancy and breastfeeding. Ringer's lactate solution is in the crystalloid family of medication. It has the same tonicity as blood. Ringer's solution was invented in the 1880s with lactate being added in the 1930s. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. Lactated Ringer's is available as a generic medication. The wholesale cost in the developing world is about US$0.60 to US$2.30 per liter. For people with poor liver function, Ringer's acetate may be a better alternative with the lactate replaced by acetate. In Scandinavia Ringer's acetate is typically used. Ringer's lactate solution is very often used for fluid resuscitation after a blood loss due to trauma, surgery, or a burn injury. Ringer's lactate solution is used because the by-products of lactate metabolism in the liver counteract acidosis, which is a chemical imbalance that occurs with acute fluid loss or kidney failure. The IV dose of Ringer's lactate solution is usually calculated by estimated fluid loss and presumed fluid deficit. For fluid resuscitation the usual rate of administration is 20 to 30 ml/kg body weight/hour. RL is not suitable for maintenance therapy (i.e., maintenance fluids) because the sodium content (130 mEq/L) is considered too low, particularly for children, and the potassium content (4 mEq/L) is too low, in view of electrolyte daily requirement. Moreover, since the lactate is converted into bicarbonate, long-term use will cause patients to become alkalotic. Ringer's lactate and other crystalloids are also used as vehicles for the IV delivery of medications. In a large-volume resuscitation over several hours, LRS maintains a more stable blood pH than normal saline.