In this episode, I’ll discuss giving lactated ringer’s solution to a patient with elevated lactate.
Lactated ringers is considered a suitable fluid for resuscitation in sepsis. In fact, it is becoming more common to use it as a resuscitation fluid as it contains a more physiologic level of chloride than normal saline and is not expected to cause hyperchloremic acidosis when given in large volumes.
Septic patients frequently have an elevated lactate, and this leads some clinicians to consider whether giving an IV solution with additional lactate is a prudent choice.
It is true that lactated ringers will increase the measured serum lactate, but this will not have a deleterious effect on patient outcomes. The lactate found in lactated ringers is not lactic acid, rather it is sodium lactate. This form of lactate will not decrease blood pH. Since lactated ringers is a crystalloid solution, it will increase blood volume and directly treat the cause of elevated lactate in sepsis.
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>will not increase blood pH
If we’re concerned with lactate worsening lactic acidosis, we wouldn’t expect the blood pH to increase. Rather, we’d be concerned with it decreasing as the acidosis worsens.
Thank you Ron!