Does sodium lactate ringer injection increase blood lactate levels?

Blood lactate levels are affected by many factors. A realistic question is, patients who need fluid resuscitation have high blood lactate, can they transfuse sodium lactate Ringer injection?

In the instructions, there is one contraindication for sodium lactate Ringer injection: when lactic acidosis has been significant.

Does sodium lactate Ringer injection increase blood lactate?

Recent volunteer-based studies have shown that after receiving 30 ml/kg sodium lactate Ringer injection, the blood lactate level increased by only 0.93 mmol/l, and the normal saline group increased by 0.37 mmol/l, and the difference between the two groups was not statistically significant[1]. An early clinical RCT study showed that an infusion of 1 l of sodium lactate Ringer injection for 1 hour did not increase blood lactate levels [2].

In the 2016sc guidelines, fluid resuscitation with balance fluid or saline is recommended in patients with sepsis or septic shock (weak recommendation, low quality of evidence).

Whether the use of balanced crystals can prevent the occurrence of acute kidney injury and reduce the mortality rate is unknown.

Discussion: What considerations limit your use of sodium lactate Ringer injection in septic shock?

bibliography

[1] zitek t, skaggs zd, rahbar a,et al. does intravenous lactated ringer's solution raise serum lactate? j emerg med. 2018 sep;55(3):313-318

[2] didwania, a., miller, j., kassel, d. et al. effect of intravenous lactated ringer’s solution infusion on the circulating lactate concentration: part 3. results of a prospective, randomized, double-blind, placebo-controlled trial. crit care med. 1997;25: 1851–1854

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