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Discussion

Lactated Ringers vs .9NS

Hello all

please help, Im preparing to take my boards and Im constantly studying. I wanted to know if you can please tell me what is the difference between Lactated Ringers Vs .09NS. I know that they are both isotonic solutions, however in what senerio would you use one on a patient versus the other.

Thanks so much I would really appreciate it.

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There aren't very many hard and fast rules where one crystalloid is favored over another. In your standard dehydrated ER patient who needs a liter or so, studies don't seem to show much difference in outcomes.

In the setting of massive blood loss requiring liters and liters of fluid resuscitation, LR may be the way to go. In that situation, giving tons and tons of NS could be associated with something known as hyperchloremic acidosis.

Blood products and colloid solutions (such as albumin) are also volume replacement options, but reactions are a concern with both. Colloids are also pretty expensive.

well your not going to use lac ringer if your doing a blood transfusion cause it will clump (agglunate) however you spell that lol. NS is a safer fluid. you also flush with that. lac ringer has carbs in it so it will bring your sugar up.

I have not seen much LR given, mostly NS. I did observe LOTS of LR being used in the OR, both IV and for flushing. I asked the nurse why they were using it and she said something like, "Well, LR is closer to the make up of your body fluids." :uhoh3: What ever the heck that means.

And never ever ever ever ever do this again:

Lactated Ringers Vs .09NS

You need a 0 before that ".9". 0.09 is correct.

  • Guides

Flushing the line with LR will not have any effect on blood transfusions/PRBCs. http://www.americanjournalofsurgery.com/article/S0002-9610(98)00011-7/abstract

http://www.dtic.mil/cgi-bin/GetTRDoc?Location=U2&doc=GetTRDoc.pdf&AD=ADA421564

We were taught in anesthesia school that it takes up to 2 liters of LR running with PRBC to cause any problems, and that I assume is only if that is with the same unit of PRBC.

Plasmalyte can also be used with PRBCs. http://www.drugs.com/pro/plasma-lyte-a.html

Although for NCLEX NS is the only IV solution to use with PRBCs!

You need a 0 before that ".9". 0.09 is correct.

It's 0.9NS - she didn't fail to have a leading zero, she transposed the decimal point and the zero.

Normal Saline is cheaper, so in situations where it doesn't matter (i.e. slow infusions in non-pregnant patients) NS is usually given. In burn patients and pregnant patients, LR is the fluid of choice.

hello all

please help, im preparing to take my boards and im constantly studying. i wanted to know if you can please tell me what is the difference between lactated ringers vs .09ns. i know that they are both isotonic solutions, however in what senerio would you use one on a patient versus the other.

thanks so much i would really appreciate it.

in a client with renal insufficiency, ns would be better than lr because ns has less electrolytes. using lr may cause potassium or sodium retention.

Think of situations where you'd want a patient to have Gatorade (LR) vs water (NS). :)

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