Being isotonic also means that when you get IV lactated Ringer’s, the solution won’t cause cells to shrink or get bigger. Instead, the solution will increase the fluid volume in your body.
Lactated Ringers vs. Normal Saline as IV Fluids
Lactated ringers and normal saline are both types of intravenous (IV) fluids. IV fluids are given whenever there is a concern about maintaining fluid balance. Each type of IV fluid has different benefits and drawbacks. Your doctor will decide whether to use lactated ringers or normal saline based on your medical condition and other medications you may be taking.
What Are Lactated Ringers and Normal Saline?
Your body is made up of about 60% water. About two-thirds of this fluid is stored in your cells. The rest is in your blood vessels and between your cells. Your brain and heart are 73% water. Your lungs are 83% water. Your muscles and kidneys are 69% water, and your skin is 64% water.
Because so much of your body is made of water, it is essential for the healthy function of every one of your cells. Some of the functions water performs in your body include:
- Helps your cells perform basic functions
- Lubricates your joints
- Regulates your internal body temperature
- Transports protein and carbohydrates
- Eliminates waste through urine and feces
- Acts as a shock absorber for your brain and spinal cord
If you lose enough fluid for any reason, your electrolytes can become imbalanced. Your body systems get stressed, and your thinking process is impaired. When you’re dehydrated your body decreases urine output, and your blood becomes thicker, which makes your heart work harder. Replacing lost fluids intravenously helps restore your body’s normal functions.
How Are Lactated Ringers and Normal Saline Similar?
Lactated ringers and normal saline are two types of fluid-replacement products. They are both crystalloid solutions. This means that they have small molecules that can easily flow through membranes, such as the cell membranes in your body’s tissues. Lactated ringers and normal saline are also both isotonic solutions. This means that they are similar to plasma in the number of dissolved particles they contain.
How Are Lactated Ringers and Normal Saline Different?
Lactated ringers and normal saline contain different ingredients that affect how they work in your body. Each one also has different side effects that can cause problems. The risks of these are discussed below in the final section of this article.
Lactated ringers contain:
- Sodium chloride
- Sodium lactate
- Potassium chloride
- Calcium chloride dihydrate
- Water for injection
By contrast, normal saline is a mixture of water and sodium chloride.
When Is It Best to Use Lactated Ringers?
Lactated ringers are more similar to your blood plasma than saline. Lactated ringers are used for:
- Burn and trauma patients who need fluids
- Acute blood loss
- Metabolic acidosis, which is an electrolyte disorder
- Electrolyte loss
When Should Lactated Ringers Be Avoided?
Lactated ringers should not be used with people who have these issues:
- Liver disease
- Lactic acidosis, which is when there is too much lactic acid in your system
- A pH level greater than 7.5
- Kidney failure
When Is It Best to Use Normal Saline?
Normal saline is the chemical name for salt. It is one of the most commonly used IV fluids and is used for most hydration needs, including:
- Blood loss
- Vomiting
- Diarrhea
- Metabolic acidosis
- Shock
- Low sodium levels
- Increased calcium levels
- As the only solution that should be given with blood products
When Should Normal Saline Be Avoided?
Normal saline should be used with caution or avoided by people who have the following issues:
- Heart disease
- Kidney disease
- Prone to fluid volume overload, which is too much water in the body
- Prone to hyperchloremia, which is too many chloride ions in the body
What Are the Possible Risks of Lactated Ringers and Normal Saline?
The risks associated with IV fluid replacement usually stem from receiving too much, too little, or the wrong type of fluid.
The risks associated with receiving too much fluid include:
- Swelling of lower legs and hands
- High blood pressure
- Respiratory failure
- Poor wound healing
The risks associated with not receiving enough fluid include:
- Fast heart rate
- Low blood pressure
- Kidney failure
- Shock
- Multiple organ failure
Finally, the risks associated with receiving the wrong type of fluid result from the wrong concentration of sodium in the blood. This can lead to changes in cell volume and function which may cause brain injury.
Show Sources
Lippincott NursingCenter: “IV Fluids.”
The Medical Journal of Australia: “Avoiding common problems associated with intravenous fluid therapy.”
NIH: “LABEL: LACTATED RINGERS- sodium chloride, sodium lactate, potassium chloride, and calcium chloride injection, solution.”
NURSE PLUS ACADEMY: “Breaking Down IV Fluids: The 4 Most Common Types and Their Uses.”
StatPearls: “Normal Saline.”
Ringer’s Lactate Solution: What It Is and How It’s Used
Lactated Ringer’s solution, or LR, is an intravenous (IV) fluid you may receive if you’re dehydrated, having surgery, or receiving IV medications. It’s also sometimes called Ringer’s lactate or sodium lactate solution.
There are several reasons why you may receive this IV fluid if you need medical care.
While saline and lactated Ringer’s solution have a few similarities, they also have differences. This can make the use of one more suitable than the other depending on the situation.
What they have in common
Normal saline and lactated Ringer’s are two IV fluids commonly used in hospital and healthcare settings.
They’re both isotonic fluids. Being isotonic means the fluids have the same osmotic pressure as blood. Osmotic pressure is a measurement of the balance of solutes (such as sodium, calcium, and chloride) to solvents (for example, water).
Being isotonic also means that when you get IV lactated Ringer’s, the solution won’t cause cells to shrink or get bigger. Instead, the solution will increase the fluid volume in your body.
How they differ
Fluid manufacturers put slightly different components in normal saline compared to lactated Ringer’s. The differences in particles mean that lactated Ringer’s doesn’t last as long in the body as normal saline does. This can be a beneficial effect to avoid fluid overload.
Also, lactated Ringer’s contains the additive sodium lactate. The body metabolizes this component to something called bicarbonate. This is a “base” that can help make the body less acidic.
For this reason, some doctors use lactated Ringer’s when treating medical conditions such as sepsis, in which the body becomes very acidic.
Some research suggests that lactated Ringer’s may be preferred over normal saline for replacing lost fluid in trauma patients.
Also, normal saline has a higher chloride content. This can sometimes cause renal vasoconstriction, affecting blood flow to the kidneys. This effect usually isn’t a concern unless a person gets a large amount of normal saline solution.
Lactated Ringer’s doesn’t mix well with some IV solutions. Pharmacies instead mix normal saline with the following IV solutions:
- methylprednisone
- nitroglycerin
- nitroprusside
- norepinephrine
- propanolol
Because lactated Ringer’s has calcium in it, some doctors don’t recommend using it when a person gets a blood transfusion. The extra calcium could bind with the preservatives added to blood by blood banks for storage. This potentially increases the risk of blood clots.
As a side note, lactated Ringer’s is also slightly different from what’s called simply Ringer’s solution. Ringer’s solution usually has sodium bicarbonate instead of sodium lactate in it. Sometimes Ringer’s solution also has more glucose (sugar) in it than lactated Ringer’s.
Lactated Ringer’s solution has a lot of the same electrolytes that blood naturally does.
According to B. Braun Medical, one of the companies that manufactures lactated Ringer’s, every 100 milliliters of their solution includes the following:
- calcium chloride: 0.02 grams
- potassium chloride: 0.03 grams
- sodium chloride: 0.6 grams
- sodium lactate: 0.31 grams
- water
These components can vary slightly by manufacturer.
Both adults and children can receive lactated Ringer’s solution. Some of the reasons why a person may get this IV solution include:
- to treat dehydration
- to facilitate the flow of IV medication during surgery
- to restore fluid balance after significant blood loss or burns
- to keep a vein with an IV catheter open
Lactated Ringer’s is often the IV solution of choice if you have sepsis or an infection so severe your body’s acid-base balance is thrown off.
Doctors may also use lactated Ringer’s as an irrigating solution. The solution is sterile (doesn’t have bacteria in it when stored properly). It can therefore be used to wash out a wound.
It can also be used during surgery to irrigate the bladder or a surgical site. This helps to wash away bacteria or make a surgical site easier to see.
Manufacturers don’t intend for people to drink lactated Ringer’s solution. It’s only meant for irrigation or IV use.
You receive lactated Ringer’s solution in an IV. When the solution goes into the vein, it goes inside cells as well as outside. Ideally, the solution helps to maintain or achieve fluid balance in your body.
Giving too much lactated Ringer’s can cause swelling and edema. Some people have medical conditions that mean their body can’t handle the extra fluid well. These conditions include:
- chronic kidney disease
- congestive heart failure
- hypoalbuminemia
- cirrhosis
If people with these medical conditions are getting lactated Ringer’s (or any other IV fluid), a medical professional should closely monitor them to ensure they aren’t getting too much fluid.
In addition to fluid overload, too much lactated Ringer’s solution could affect your electrolyte levels. This includes sodium and potassium. Because there is less sodium in lactated Ringer’s than there is in the blood, your sodium levels could become too low if you get too much.
Some lactated ringers solutions include dextrose, a type of glucose. Allergic reactions may occur in people who have corn allergies.
The dose for lactated Ringer’s depends on the circumstances. A doctor will consider factors such as your age, how much you weigh, your overall health, and how hydrated you already are.
Sometimes a doctor may order IV fluids at a “KVO” rate. This stands for “keep vein open,” and is usually about 30 milliliters per hour. If you’re very dehydrated, a doctor may order fluids infused at a very fast rate, such as 1,000 milliliters (1 liter).
If you have to have an IV, you may see that your IV bag reads “lactated Ringer’s.” This is a time-tested option for fluid replacement that doctors commonly prescribe. If you do receive it, you’ll be monitored to make sure that you don’t get too much through your IV.
Last medically reviewed on January 10, 2020
How we reviewed this article:
Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.
- Jung KT, et al. (2016). Effect of hydroxyethyl starch on blood glucose levels. DOI:
10.4097/kjae.2016.69.4.350 - Lactated Ringers – sodium chloride, sodium lactate, potassium chloride, and calcium chloride injection, solution. (2017).
dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d3d29c8f-c326-4097-814a-7f4e08c67068 - Mane AS. (2017). Fluid resuscitation: Ringer lactate versus normal saline – a clinical study.
ijcmr.com/uploads/7/7/4/6/77464738/ijcmr_1756_v1.pdf - Singh S, et al. (2019). Ringer’s lactate. StatPearls.
ncbi.nlm.nih.gov/books/NBK500033/
About Us
Family Medicine
In 2024 our team of doctors and nurses provide a comprehensive range of family planning services. Our doctors have expertise in antenatal care, preconception planning, and STD checks. Contraceptive advice including Mirena and Implanon insertion is available.
- Early detection of illness;
- Family planning;
- Promotion of healthy lifestyle;
- Skin cancer checks;
- Sports injuries;
- Weight reduction;
- Workers compensation and third party.
Children's Health
Baby Weighing Service. Babies can be booked with our Nurse for weighing, a doctors appointment is not required to use this service. Contact reception for a appointment to have your baby weighed.
Immunisations. At Tuggeranong Square children's immunisation is regarded an important part of your childs health care. Our doctors take immunising children very seriously. and to ensure all children are immunised Tuggeranong Square Medical Practice doctors BULK BILL for all childhood immunisations. Tuggeranong Square Medical Practice also ensures the Practice Nursing Staff are highly trained in childhood immunisations.
Women's Health
Our practice is dedicated to treating a wide spectrum of women’s health concerns. We offer pre-natal, antenatal and postnatal care, contraceptive options, pap screening, and preventative health care advice. We provide assistance, advice and support through all stages of life, recognising the many issues many women may face from adolescence through to the peri and post-menopausal period.
- Cervical Screening tests;
- Reproductive health. Including Mirena and Implanon insertion;
- Shared antenatal care.
Men's Health
We encourage men to present routinely to their GP to discuss all aspects of their health. We provide comprehensive advice and support for men to address the prevention and management of various health conditions. This may include assessments for cardiovascular risk, diabetes, cancer prevention, mental health assessments, STD screening, sports injuries and the importance of sleep as it relates to other areas of health.
- Preventative Healthcare. Including cardiovascular screening, mental health and cancer checks;
- Prostate examination.
