Why Lactated Ringers in Postpartum?

Start2 · Jan 8, 2011

Hi:

http://www.drugs.com/pro/lactated-ringers.html

This link will take you to a site that will give you information on why Lactated Ringers' solution might be ordered instead of Normal Saline solution postpartum.

You will have to scroll down a ways to find the section for Labor and Delivery.

Good Luck

:heartbeat

GilaRRT · Jan 8, 2011

I just started working on a postpartum floor as a new grad and I was wondering why the main iv solution used is Lactated Ringers instead of Normal saline?
Thanks

Physician preference most likely. I am not aware of any smoking gun evidence for or against either unless a specific underlying condition such as hyperkalaemia, altered lactate metabolism, hyperchloraemic acidosis or some other problem creates clear risks and benefits when choosing a solution.

newtress, LPN · Jan 9, 2011

Thanks Start2 for posting the link for lactated ringers. That was one of the most thorough and comprehensive overviews on lactated ringers. Much more there than was ever introduced to me in school. I'd like to have this info for future reference as the ringers can be contraindicated in quite a few patient scenarios.

klone, MSN, RN · Jan 9, 2011

I know that for all our postpartum women who have IVs (which is pretty much just the s/p C/S), we give D5LR.

cschoppe · Jan 9, 2011

I'm a student (4th semester) and just read something in my OB book about how women in labor use up lots of fluid and after delivery their body is trying to rid that fluid, and as a result they may experience dehydration which may be an indication for LR...also their bodies are trying to readjust to the new state of being non-pregnant which includes a shrinking blood supply and their plasma volume decreases initially to try to make up for the change in blood situation so maybe the fluid is leaving the plasma to make up the blood and this may result in loss of fluids? not sure, and its hard to put into words what exactly im trying to explain haha

dthfytr, ADN, LPN, RN, EMT-B, EMT-I · Jan 9, 2011

In major trauma patients LR is used so that the liver can store the lactate for later use in maintaining acid base balance. The drawback is that you can't give blood with LR because the K will lyse RBC's. Don't know if this helps the thread or not, L&D is my weakest area. 25 years and never delivered a single baby, but I lost count of how many I took from the floor or back seat only minutes old.

When I worked EMS (they had just invented the wheel) I had partners deliver 2 babies a shift. I'd like to have had the opportunity, but as the years went by and coworkers had more and more stories it became a humorous challenge to see how long I could go WITHOUT delivering a BB.

netglow, ASN, RN · Jan 9, 2011

Maternal dehydration in prolonged labor.

GilaRRT · Jan 9, 2011

In major trauma patients LR is used so that the liver can store the lactate for later use in maintaining acid base balance. The drawback is that you can't give blood with LR because the K will lyse RBC's. Don't know if this helps the thread or not, L&D is my weakest area. 25 years and never delivered a single baby, but I lost count of how many I took from the floor or back seat only minutes old.
When I worked EMS (they had just invented the wheel) I had partners deliver 2 babies a shift. I'd like to have had the opportunity, but as the years went by and coworkers had more and more stories it became a humorous challenge to see how long I could go WITHOUT delivering a BB.

Potassium is not the issue with packed cells. We add a citrated solution to banked blood. This results in the chelation of calcium and inactivation of the clotting cascade. Because LR contains calcium, it is possible that concomitant administration of blood products with LR could potentially result in clot formation.

netglow, ASN, RN · Jan 9, 2011

Oops, forgot bolus for epidural.

klone, MSN, RN · Jan 9, 2011

Oops, forgot bolus for epidural.

You didn't answer *why* though. Why LR over NS?

netglow, ASN, RN · Jan 9, 2011

Oh, better volume expander than NS, for hypotension.