D50 with LR

[perimeter]

Are there any reasons not to push D50 through an IV line of Lactated Ringer's? I couldn't find any listed as a contraindication, I've just never thought about it.

 

[NYMedic828]

Are there any reasons not to push D50 through an IV line of Lactated Ringer's? I couldn't find any listed as a contraindication, I've just never thought about it.

Lactated ringers is considered to be interchangeable with N.S as far as I know.

 

[perimeter]

except in the case of a blood transfusion? I thought there were certain drugs that would react to the lactate.

 

[firecoins]

should have no problem with D50. It is a common enough drug that a contraindication would be listed.

 

[jwk]

Are there any reasons not to push D50 through an IV line of Lactated Ringer's? I couldn't find any listed as a contraindication, I've just never thought about it.

No problem at all.

 

[Christopher]

except in the case of a blood transfusion? I thought there were certain drugs that would react to the lactate.

I think it is the calcium with the blood transfusions, but as far as I can tell you shouldn't KVO blood thru LR...otherwise a rapid flow will be fine.

Lorenzo M, et al. Can Ringer's lactate be used safely with blood transfusions? Am J Surg 1998. 175(4):308-10. (PubMed)

BACKGROUND:
Blood bank recommendations specify that Ringer's lactate solution (LR) should be avoided while transfusing blood. However, there are few studies either evaluating or quantifying increased coagulation during rapid infusion of LR and blood.
DESIGN AND METHODS:
Whole blood (WB, n = 25) and packed red blood cells (PRBC, n = 26) were rapidly admixed with normal saline (NS), Lactate solution and LR with 1 g (LR-1), 2 g (LR-2), and 5 g (LR-5) CaCl2/L solutions for assessment of infusion time, filter weight, and clot formation.
RESULTS:
No significant differences in infusion time or filter weight using WB or PRBC with NS or LR were seen. No significant difference in clot formation between NS and LR with WB or PRBC was found, but the presence of visible clot was increased in the LR-5 group (P = 0.013, WB, and P = 0.002, PRBC).
CONCLUSION:
A comparison of LR and NS with rapid infusion rates of blood showed no significant difference between infusion time, filter weight and clot formation. Blood bank guidelines should be revised to allow the use of LR in the rapid transfusion of PRBC.