Ringer's Solution

What is Ringer Solution?

Ringer's solution is a mixture of salts dissolved in water that is used to make an isotonic solution similar to an animal's body fluids. Sodium chloride, potassium chloride, calcium chloride, and sodium bicarbonate are commonly used in Ringer's solution, with the latter being used to stabilise the pH. Chemical fuel sources for cells, such as ATP and dextrose, as well as antibiotics and antifungals, are possible additions.

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Ringer Solution Composition 

Ringer's solution is a concentrated water solution containing NaCl, KCl, CaCl2, and NaHCO3, as well as other minerals including MgCl2. The exact proportions of these vary by species, particularly between marine osmoregulators and osmoconformers.


Insect Ringer Solution Recipe (Yamasaki and Narahashi, 1963) 



Cockroach

Silkworm

Japanese beetle

NaCI (g/1000 ml)

12.2

8.6

9.8

KCI (g/1000ml)

0.21

0.10

0.77

CaCI, (g/1000ml)

0.20

0.33

0.38

Buffer

*

**

*


*M/15 Na,HPO.: MIlS KH,PO. = 9: 1,50 ml, pH = 7.2 

**M/15 Na,HPO. : MIlS KH,PO. = 4 : 6, 50 ml, pH = 6.6


Invertebrate Ringer Solution Composition 



NaCI

(g/1,000 ml)

KCI

(g/1,000 ml)

CaCI2

(g/1,000 ml)

NaHCO3

(g/1,000 ml)

MgCI2

(g/1,000 ml)

Grasshopper

9.0

0.2

0.2

0.2

-

Silkworm

11.2

0.24

0.27

0.2

-

Drosophila

7.5

0.35

0.21

0.2

-

Earthworm

4.4

0.1

0.1

0.2

-

Seawater crab

25.0

2.6

2.3-3.0

0.7

1.6

Freshwater crab

12.0

0.4

1.5

0.2

0.2


Steps to be Followed to Prepare a Ringer Solution

Reagents

  • 7.2 g sodium chloride - NaCl

  • 0.37 g potassium chloride - KCl

  • 0.17 g calcium chloride - CaCI2

Procedure

  1. In a beaker, add 500 ml of distilled water.

  2. Using distilled water, dissolve the reagents in the beaker.

  3. Add water to bring the final volume to one litre.

  4. Adjust the pH to 7.3-7.4.

  5. Filter the solution through a 0.22-μm filter.

  6. Autoclave Ringer's solution prior to use.


Use of Ringer Solution 

In vitro tests on organs or tissues, such as in-vitro muscle research, commonly use of Ringer solution. The exact mix of ions varies by taxon, with various recipes for birds, mammals, freshwater fish, and marine fish, for example. It may also be used for medical reasons, such as arthroscopic lavage for septic arthritis. When treating isotonic dehydration, it's used to replace extracellular fluid losses and restore chemical balances are some of the uses of ringer solution.


History 

Sydney Ringer discovered in 1882–1885 that a solution perfusing a frog's heart must contain sodium, potassium, and calcium salts in a certain proportion if the heart is to be kept beating for an extended period of time. Alexis Hartmann modified the use of ringer's solution in the 1930s by adding sodium lactate to create Ringer's lactate solution.


How is Ringers Lactate Solution Different from Saline?

Although there are some similarities between saline and lactated Ringer's solution, there are also some variations. Depending on the severity, this can make one more acceptable than the other.


What Do They Have in Common?

Two IV fluids widely used in hospitals and healthcare settings are normal saline and lactated Ringer's. Both are isotonic fluids. When fluids are isotonic, they have the same osmotic pressure as blood. The balance of solutes (such as sodium, calcium, and chloride) to solvents is measured by osmotic pressure (for example, water). Since the solution is isotonic, it won't cause cells to shrink or grow when you get IV lactated Ringer's. Instead, the solution will increase the body's fluid content.


How Do They Differ?

In comparison to lactated Ringer's, regular saline contains slightly different components. Lactated Ringer's does not last as long in the body as regular saline due to particle variations. This may be a helpful result in preventing fluid overload.


Lactated Ringer's also incorporates the sodium lactate additive. This portion is metabolised by the body into bicarbonate. This is a “base” that can aid in the reduction of acidity in the body.


As a result, some physicians prescribe lactated Ringer's for medical conditions like sepsis, in which the body becomes extremely acidic. Lactated Ringer's may be favoured over regular saline for replacing the missing fluid in trauma patients, according to some studies.


In addition, regular saline contains more chloride. Renal vasoconstriction, which reduces blood flow to the kidneys, may occur as a result of this. If a person is given a large amount of regular saline solution, this effect is normally not a problem. Some IV solutions don't pair well with lactated Ringer's. Instead, pharmacies blend standard saline with the IV solutions mentioned below:

  • methylprednisolone

  • nitroglycerin

  • nitroprusside

  • norepinephrine

  • propranolol

Since lactated Ringer's contains calcium, some physicians advise against using it during a blood transfusion. The extra calcium could bind with the preservatives that blood banks use to keep blood safe for storage. Blood clots can become more likely as a result of this.


Lactated Ringer's solution differs from plain Ringer's solution in a few ways. Instead of sodium lactate, Ringer's solution typically contains sodium bicarbonate. Ringer's solution can contain more glucose (sugar) than lactated Ringer's solution.


Medical Uses of Lactated Ringer’s Solution

Lactated Ringer's solution can be provided to both adults and children. An individual can receive this IV solution for a variety of reasons, including:

  • To treat dehydration.

  • During surgery, to make it easier for IV medicine to run.

  • After major blood loss or burns, fluid equilibrium must be restored.

  • To keep a vein with an IV catheter open.

If you have sepsis or an infection that has thrown the body's acid-base balance off, lactated Ringer's is always the IV treatment of choice. Lactated Ringer's may also be used as an irrigating solution by doctors. The solution is sterile (it does not contain bacteria when properly stored). As a result, it can be used to clean a cut. It may also be used to irrigate the bladder or a surgical site during surgery. This aids in the removal of bacteria or the visibility of a surgical site. People are not supposed to drink lactated Ringer's solution, according to the manufacturers. It's just for irrigation or intravenous application.


Do you know? 

Why are ringers called lactated? Lactated or acetated Ringer's solutions, named after a British physiologist, or Hartmann's solution, named after a United States paediatrician who added lactate as a buffer to prevent acidosis in septic children in the 1930s.

FAQs (Frequently Asked Questions)

1. When Should You Not Give Lactated Ringer's?

Answer. Where the administration of sodium, potassium, calcium, chloride, or lactate may be clinically harmful, this solution is contraindicated. Lactate administration is not recommended in cases of extreme metabolic acidosis or alkalosis, as well as in cases of severe liver disease or anoxic conditions that impair lactate metabolism.

2. What is an Acetated Ringer Solution?

Answer. For elderly patients undergoing septic shock surgery, acetated ringers solution, which can lower serum lactic acid, correct acidosis, increase microcirculation, and maintain body temperature during surgery, is preferable.

3. What is the Difference Between Ringer Lactate and Normal Saline?

Answer. Lactated Ringer's does not last as long in the body as regular saline due to particle variations. This may be a helpful result in preventing fluid overload. Lactated Ringer's also incorporates the sodium lactate additive. This portion is metabolised by the body into bicarbonate.

4. How to Make a Frog Ringer Solution?

Answer. To make the solution, in a beaker add 500 ml of distilled water and then dissolve the reagents into the beaker with distilled water. Further, add water to bring the final volume to one litre and adjust the pH to 7.3-7.4. Then filter the solution through a 0.22-μm filter and Autoclave Ringer's solution prior to use.