Ringer's lactate (Hartmann's solution)
A balanced crystalloid for resuscitation and fluid replacement. First-choice fluid in dengue, burns, severe dehydration and most surgical patients.
Common brands in Pakistan: Ringer's lactate (RL) infusion from several local manufacturers. Brand availability changes; check with your pharmacy.
On this page
Composition (per litre)
| Component | Amount |
|---|---|
| Sodium | 130 mmol |
| Chloride | 109 mmol |
| Potassium | 4 mmol |
| Calcium | 1.5 mmol (about 3 mEq) |
| Lactate | 28 mmol |
| Osmolarity | About 273 mOsm/L |
Uses
Dose
| Situation | Dose |
|---|---|
| Fluid bolus, adult | 500 mL over under 15 minutes, then reassess (250 mL if heart failure is possible) |
| Fluid bolus, child | 10 mL/kg (20 mL/kg in some protocols), then reassess |
| Severe dehydration, child (Plan C) | 100 mL/kg: 30 mL/kg then 70 mL/kg (see the ORS and Plan C calculator) |
| Burns (Parkland) | 4 mL × kg × % burn in 24 hours, half in the first 8 hours (see the Parkland calculator) |
| Dengue with warning signs | 5–7 mL/kg/hour for 1–2 hours, then step down (see dengue) |
Cautions
- Contains a little potassium: use with care in severe high potassium, but it is not usually harmful in mild hyperkalaemia.
- Slightly hypotonic: avoid large volumes in head injury and raised intracranial pressure (use 0.9% saline).
- Contains calcium: do not run in the same line as blood or ceftriaxone.
- Severe liver failure reduces lactate metabolism.
Frequently asked questions
Is Ringer's lactate better than normal saline?
For most resuscitation and surgical patients, balanced crystalloids like Ringer's lactate cause less hyperchloraemic acidosis than large volumes of 0.9% saline. Normal saline is preferred in head injury, hyponatraemia and some metabolic alkalosis.
Can Ringer's lactate be given with blood?
No. The calcium can cause clotting in the line. Use 0.9% saline with blood products.
Used in these guides
- Acute kidney injury (AKI)
- Acute pancreatitis
- Burns
- Dengue fever
- Diarrhoea and dehydration in children
- Gastroenteritis in adults
- Heat stroke
- Low blood pressure on the ward
- Low urine output
- Perforated viscus and peritonitis
- Post-operative complications
- Prescribing IV fluids
- Sepsis in children
- The deteriorating patient and NEWS2
- The febrile child
- The shocked patient
Sources
Doses on this page are typical doses from the sources above. Always confirm with a current drug reference, the product leaflet and your hospital protocol, especially in children, pregnancy and kidney or liver disease.