Lactated Ringer's solution contains isotonic concentrations of electrolytes in water for inj. It is used for parenteral replacement of extracellular losses of fluid and electrolytes. Lactated Ringer’s Injection, produces a metabolic alkalinizing effect. Lactate ions are metabolized ultimately to carbon dioxide and water, which requires the consumption of hydrogen cations.

Calcium chloride is used to prevent or treat negative calcium balance. It also regulates action potential excitation threshold to facilitate nerve and muscle performance.

Potassium chloride is a major cation of the intracellular fluid. It plays an active role in the conduction of nerve impulses in the heart, brain and skeletal muscle; contraction of cardiac skeletal and smooth muscles; maintenance of normal renal function, acid-base balance, carbohydrate metabolism and gastric secretion.

Sodium chloride is the major extracellular cation. It is important in electrolyte and fluid balance, osmotic pressure control and water distribution as it restores sodium ions. It is used as a source of electrolytes and water for hydration, treatment of metabolic acidosis, priming solution in haemodialysis and treatment of hyperosmolar diabetes. It is also used as diluents for infusion of compatible drug additives.

One Liter Ringer's lactate solution Contains-

• Na⁺ 127 mEq
• K⁺ 4 mEq
• Ca⁺⁺ 4 mEq
• Cl^- 155 mEq 

Each 100 ml of Ringer's lactate solution contains-

• Sodium chloride 600 mg
• Anhydrous sodium lactate 310 mg
• Potassium chloride 30 mg
• Calcium chloride dihydrate 20 mg

Ringer's lactate solution is indicated for diarrhea, dehydration, water and electrolytes imbalance, alkalinizing agent, diabetic coma, cholera. This 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 renal 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, longterm use will cause patients to become alkalotic. Ringer's lactate and other crystalloids are also used as vehicles for the IV delivery of drugs.

In a large-volume resuscitation over several hours, LRS maintains a more stable blood pH than normal saline.

Hypersensitivity.

Reactions which may occur because of the solution or the technique of administration include febrile response, infection at the site of injection, venous thrombosis or phlebitis extending from the site of injection, extravasation, and hypervolemia.

IV infusion is obsolete in metabolic acidosis and carries the risk of producing lactic acidosis, particularly in seriously ill patients with poor tissue perfusion and on impaired hepatic function.

Pregnancy & Lactation

Pregnancy Category C. Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks

Nursing Mothers: It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when 5% Dextrose in Lactated Ringer’s Injection is administered to a nursing woman.