#LACTATED RINGER VS NORMAL SALINE DOWNLOAD#
#LACTATED RINGER VS NORMAL SALINE FREE#

Shownotes Written By: Miguel Reyes, MD (Twitter: Peer Reviewed By: Salim R. Ceftriaxone and LR should never be running at the same time in children less than 28 days old.Ampicillin, Carbapenems, Phenytoin, Potassium Phosphate, Nicardipine Certain medications cannot be run with LR in the same IV line.For large volume resuscitations, LR is a better choice. SALT ED and SMART trials show normal saline may increase the occurrence of major kidney events in comparison to a balanced solution like LR.When compared to Normal Saline, Lactated Ringers is a more balanced solution and more closely resembles our serum.Not a significant amount of data but believed that lactate might increase slightly with lactated ringers infusion.Shouldn’t infuse with LR even in seperate lines in kids under 28 days of age.

Can infuse in adults in different lines in different limbs as above.

Can infuse in the same patient at the same time in different lines in different limbs.

Medications that can’t go in the same IV line.

However, if you think you will be giving a significant amount of fluid to say a patient with DKA or HHS please consider using a balanced solution LR Considerations In patients getting 1L of fluid it likely doesn’t matter much which of the fluid types you’re giving. Outcomes may be worse if larger amounts of fluids are given. In the studies patient were getting modest amount of fluids. Read the critiques of the articles but it looks like there is a signal in the data showing increased adverse kidney events with 0.9 saline in comparison to balanced solutions

MAKE-30 (primary outcome) lower in balanced solution group.

Lower incidence of major adverse kidney events at 30 days (MAKE-30) with balanced solutions.

#LACTATED RINGER VS NORMAL SALINE FREE#

Looked at a primary outcome of hospital free days, no diff between two fluids.

Systemic inflammatory response syndrome (SIRS) at 24 and 48 h, mortality, presence of local complications and inflammatory markers were measured. Each group received Normal Saline solution (NSS) or Lactated Ringers solution (LRS) through a goal-directed fluid resuscitation protocol. Found equal occurrence of renal replacement therapy and mortality The patients were randomized into two groups.No difference between 0.9% saline and balance fluid in terms of AKI.Has been shown to start an inflammatory cascade in animal models.

#LACTATED RINGER VS NORMAL SALINE DOWNLOAD#

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Lactated ringer vs normal saline