UMEM Educational Pearls

Does Lactated Ringer's Raise Serum Lactate?

  • Intravenous fluid administration is a cornerstone of resuscitation and the treatment of many critically ill ED patients.
  • Recent publications have suggested that balanced crystalloid solutions may be better than 0.9% normal saline (NS) for select conditions.
  • Lactated Ringer's (LR) is a common balanced crystalloid solution often used for fluid resuscitation in critically ill patients.
  • AS LR contains approximately 28 mmol/L of sodium lactate, the question of whether LR elevates serum lacate is frequently asked.
  • In a recent small, randomized, double-blind, controlled trial, investigators randomized healthy volunteers to receive 30 ml/kg of either 0.9% NS or LR. The authors report no statistical difference in the mean serum lactate when comparing LR to 0.9% NS.

References

Zitek T, et al. Does intraveneous lactated ringer's solution raise serum lactate? J Emerg Med. 2018; 55:313-8.