Lactated Ringer's (LR), also known as Ringer's lactate or Hartmann solution, is the most physiologically adaptable fluid because its electrolyte content is most closely related to the composition of the body's blood serum and plasma. Because of this, LR is another choice for first-line fluid resuscitation for certain patients, such as those with burn injuries. It contains 130 mEq/L of sodium, 4 mEq/L of potassium, 3 mEq/L of calcium, and 109 mEq/L of chloride. LR doesn't provide calories or magnesium, and has limited potassium replacement.2
LR is used to replace GI tract fluid losses, fistula drainage, and fluid losses due to burns and trauma. It's also given to patients experiencing acute blood loss or hypovolemia due to third-space fluid shifts.6 Both 0.9% sodium chloride and LR may be used in many clinical situations, but patients requiring electrolyte replacement (such as surgical or burn patients) will benefit more from an infusion of LR.6
LR is metabolized in the liver, which converts the lactate to bicarbonate. As an alkalinizing solution, LR is often administered to patients who have metabolic acidosis. Don't give LR to patients who can't metabolize lactate for some reason, such as those with liver disease or those experiencing lactic acidosis.
Because a normal liver will convert it to bicarbonate, LR shouldn't be given to a patient whose pH is greater than 7.5. Because it does contain some potassium, use caution in patients with renal failure.3