Acetated Ringer's

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Acetated Ringer's solution, also known as Ringer's acetate solution, is a solution that is isotonic with blood and intended for intravenous administration. It is abbreviated as "AR" or "RA".

Contents

[edit] Ingredients

One liter of Acetated Ringer's Solution contains:

  • 130 mEq of sodium ion.
  • 109 mEq of chloride ion.
  • 28 mEq of acetate.
  • 4 mEq of potassium ion.
  • 3 mEq of calcium ion.

Generally, the sodium, chloride, potassium and acetate come from NaCl (sodium chloride), NaCH3COO (sodium acetate), CaCl2 (calcium chloride), and KCl (potassium chloride).

These concentrations vary minutely by manufacturer. Ringer's acetate solution is commonly mixed with a 5% dextrose solution. (Svensen)

[edit] Therapy

Acetated Ringer's Solution is often used for fluid resuscitation after a blood loss due to trauma, surgery, or a burn injury, as well as hypovolemic shock due to severe dehydration and dengue hemorrhagic fever. It is used because the byproducts of acetate metabolism counteract acidosis, a chemical imbalance that occurs with acute fluid loss, such as occurring in diarrhea.

The metabolism of acetate is mainly in muscle and 2.5 to 4 times faster than lactate (see lactated Ringer's solution).

The intravenous dose of Acetated Ringer's Solution is usually calculated by estimated fluid loss and presumed fluid deficit. For fluid resuscitation the usual rate of administration is 20 to 30 ml/kg body weight/hour. Ringer's acetate is generally not suitable for maintenance therapy because the sodium content (130 mEq/L) is considered too high, particularly for children, whereas the potassium content (4 mEq/L) is too low, in view of electrolyte daily requirement.

[edit] Other Uses

Acetated Ringer's solution is also indicated as fluid therapy for acute stroke complicated by dehydration, and priming solution for cardiopulmonary bypass, intraoperative fluid therapy.

[edit] Brandnames

ASERING (marketed by Otsuka Indonesia) ACETAR (marketed by Thai Otsuka) Veen D (marketed by Hoechst Marion Roussel, in Japan)

[edit] References

  • Skutches CL et al. Plasma Acetate Turnover and Oxidation. J Clin Invest, Vol 64 September 1979, pages 708-713.
  • Pramuan, P. (1986). "The uses of acetated-Ringer's solution", Chulalongkorn Medical Journal 1986 Mar; 30(3): 221-7
  • Sekiguchi, M. (2000) "Utility of Ringer's Acetate Solution as an Intraoperative Fluid during Cardiovascular Surgery with *Cardiopulmonary Bypass", JAPANESE JOURNAL OF ANESTHESIOLOGY, VOL 49; PART 5, pages 530-534
  • Svensén, Christer MD, PhD; Fredrik Sjöstrand, MD; Robert G. Hahn, MD, PhD (2001), "Volume Kinetics of Intravenous Fluid *Therapy in the Prehospital Setting", Prehosp Disast Med 2001;16(1): 9-13.
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