Does Intravenous Lactated Ringer’s Solution Raise Serum Lactate?

Zitek, Tony; Skaggs, Z.D.; Rahbar, Aryan; Patel, Jayme; Khan, M. Taqiuddin

doi:10.1016/j.jemermed.2018.05.031

Cited by 22 publications

(14 citation statements)

References 13 publications

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“…Studies have shown that administration of large volumes of lactated Ringer's solution can decrease serum osmolality but only temporarily, with return to almost baseline observed within an hour 16 . A randomized double‐blinded study evaluating the incidence of hyperlactatemia in 30 healthy adult patients receiving normal saline or lactated Ringer's solution did not show the development of hyponatremia 17 . Therefore, the authors consider it unlikely that the administration of lactated Ringer's caused the dog's hypoosmolality.…”

Section: Discussionmentioning

confidence: 99%

Syndrome of inappropriate antidiuretic hormone secretion secondary to trauma in a dog

Cilli

Bellis

2021

J Vet Emergen Crit Care

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Objective To describe a case of inappropriate antidiuretic hormone (ADH) secretion in a dog secondary to trauma. Case Summary A 14‐year‐old neutered female mixed breed dog presented for evaluation of bite wounds. The dog sustained multiple puncture wounds to the cervical area, stifle, and elbow. Treatment was initiated with isotonic crystalloid fluids, analgesia, broad‐spectrum antimicrobials, and gastroprotectants. The dog developed hyponatremia with concurrent serum hypoosmolality and inappropriate urine hyperosmolality and urine sodium secretion, leading to a diagnosis of the syndrome of inappropriate ADH secretion. The hyponatremia improved, and the dog improved clinically and was discharged 3 days after admission. New or Unique Information Provided This is the first case description of the syndrome of inappropriate ADH secretion in a dog suffering from trauma. Inappropriate ADH secretion is largely under‐recognized in veterinary patients. Increased awareness of this syndrome can lead to initiation of appropriate treatment and improved outcomes.

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Section: Discussionmentioning

confidence: 99%

Syndrome of inappropriate antidiuretic hormone secretion secondary to trauma in a dog

Cilli

Bellis

2021

J Vet Emergen Crit Care

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“…Even though, a previous study reported that the serum lactate level rose after a 30 cc/kg bolus of LRS was given to healthy subjects. 14 The mechanism of hyperlactatemia in septic patients is different from healthy patients. Lactate is metabolized by direct oxidation or as a source of glucose using both the liver and kidney.…”

Section: Discussionmentioning

confidence: 99%

“…Sample size was calculated based on the Zitek et al study. 14 We calculated sample size (n) from this formula. We used hypothesis testing two independent means.…”

Section: Data Collectionmentioning

confidence: 99%

Normal Saline Solution or Lactated Ringer’s Solution to Enhance Lactate Clearance in Septic Patients After Initial Resuscitation in the ED: A Retrospective Cohort Trial

Limapichat¹,

K²

2021

OAEM

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Objective: To compare the effect of isotonic crystalloid solutions between lactated Ringer's solution (LRS) and normal saline solution (NSS) on lactate clearance in septic patients at the emergency department (ED). Materials and Methods:This study is a single-center retrospective chart review. The study enrolled patients older than 18 years with sepsis and initial serum lactate level >2 mg/dL in the ED. The primary outcome was to determine which isotonic solution was better for serum lactate clearance in septic patients. The secondary outcomes were serum creatinine change within 24 h and the 48-h survival rate after admission. Results: A total of 120 patients were enrolled with a median crystalloid volume administered in the ED of 1000 mL. Within 2 h of resuscitation, there was no difference in lactate clearance between the LRS and NSS groups with median values of 29.2% and 25%, respectively (P=0.839). The 48-h survival rate after admission did not differ between the LRS and NSS groups with median values of 90% and 86%, respectively. Both isotonic solutions increased serum creatinine levels within 24 h of treatment with median values of 0.3 for each group (P=0.647). Conclusion: Among septic patients in the ED treated with NSS or LRS, there was no difference in lactate clearance, serum creatinine change within 24 h, or 48-h survival. However, several factors were associated with increased lactate levels, such as older age and use of vasopressors and immunosuppressive agents.

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“…There are factors that cause a rise in lactate levels that are unrelated to the severity of illness. Resuscitation with Ringer's lactate [25] or large volume blood transfusions can raise the lactate levels. Use of vasopressors in resuscitation may also cause a rise in lactate levels [26].…”

Section: Limitationsmentioning

confidence: 99%

Mean core to peripheral temperature difference and mean lactate levels in first 6 hours of hospitalisation as two indicators of prognosis: an observational cohort study

Gupta

Puliyel

Garg³

et al. 2020

BMC Pediatr

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Background To study mean core to peripheral temperature difference (CPTD) and the mean lactate levels over the first 6 h of admission to hospital, as indicators of prognosis in critically ill children. Methods A prospective observational study in a tertiary level Pediatrics ICU in Delhi, India. Seventy eight paediatric patients from 1 month to 12 years were studied. Children with physical trauma, post-surgical patients and patients with peripheral vascular disease were excluded. Core temperature (skin over temporal artery) to peripheral temperature (big toe) difference was measured repeatedly every minute over 6 h and mean of temperature difference was calculated. Pediatric Risk of Mortality (PRISM) II, lactate clearance and mean lactate levels during that time were also studied. In-hospital mortality was used as the outcome measure. Results Mean temperature difference During the first 6 h after admission the mean temperature difference was 9.37 ± 2 °C in those who died and 3.71 ± 2.27 °C in those who survived (p < 0.0001). The area under the receiver operating curve (AUROC) was 0.953 (p < 0.0001). The comparable AUROC of PRISM II was 0.999 (p < 0.0001). Mean Lactate Mean lactate level in the first 6 h was 7.1 ± 2.02 mg/dl in those who died compared to 2.86 ± 0.87 mg/dl in those who survived (p < 0.0001). The AUROC curve for mean lactate was 0.989 (95% CI = 0.933 to 0.999; p < 0.0001). AUROC for the lactate clearance was 0.682 (p = 0.0214). Conclusions The mean core to peripheral temperature difference over the first 6 h is an easy-to-use and non-invasive method that is useful to predict mortality in children admitted to the Pediatric ICU. The mean lactate during the first 6 h of Pediatric ICU admission is a better index of prognosis than the lactate clearance over the same time period. They may be used as components of a scoring system to predict mortality.

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Does Intravenous Lactated Ringer’s Solution Raise Serum Lactate?

Cited by 22 publications

References 13 publications

Syndrome of inappropriate antidiuretic hormone secretion secondary to trauma in a dog

Syndrome of inappropriate antidiuretic hormone secretion secondary to trauma in a dog

Normal Saline Solution or Lactated Ringer’s Solution to Enhance Lactate Clearance in Septic Patients After Initial Resuscitation in the ED: A Retrospective Cohort Trial

Mean core to peripheral temperature difference and mean lactate levels in first 6 hours of hospitalisation as two indicators of prognosis: an observational cohort study

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