Ringerʼs lactate (RL) and balanced Ringerʼs solution (BR) during elective Caesarean delivery in spinal anaesthesia: effects on neonatal homeostasis

Comparison of Balanced Crystalloid Solutions: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…The balanced crystalloids that were studied include Plasmalyte (Plasma-Lyte 148/Plasma-Lyte A), Kabilyte, Normosol-R, Ringer’s Lactate, Ringerfundin/Ringer’s Acetate, Hartmann’s solution, Ringer’s Bicarbonate, Sterofundin, and novel balanced solutions (see Table 2 for a summary of commercially available fluids and their electrolyte concentrations). Of the included studies, 16 were performed in the perioperative setting ( n = 1142 participants) ( 16 – 20 , 23 , 25 , 26 , 28 , 30 – 32 , 35 , 36 , 38 , 39 ), six in the ICU ( n = 427 participants) ( 21 , 27 , 29 , 33 , 34 , 37 ), one in the emergency department (ED; n = 90 participants) ( 24 ), and one in healthy volunteers ( n = 14 participants) ( 22 ). Five studies involved pediatric patients ( n = 298 participants) ( 16 , 17 , 25 , 38 , 39 ), whereas the remainder focused on adult participants.…”

“…Most studies ( n = 19) reported only short-term metabolic outcomes ( 16 – 22 , 24 – 27 , 29 – 32 , 34 , 37 – 39 ), while a few ( n = 5) reported longer term clinical outcomes ( 23 , 28 , 33 , 35 , 36 ). Six studies were available as abstract only ( 21 , 25 , 27 , 33 , 34 , 38 ). A summary table of main outcomes of interest is available in Supplemental Digital Content, Table 2 ( http://links.lww.com/CCX/A585 ).…”

“…One RCT ( n = 102) compared Ringer’s Lactate with Balanced Ringer’s in pregnant women undergoing cesarean section ( 25 ) and found no difference in postinfusion lactate or pH between the groups. Another RCT ( n = 20) compared administration of Ringer’s Lactate with a novel balanced solution (created to have an SID equal to individual patient’s serum bicarbonate concentration) in those with acute respiratory failure requiring extracorporeal membrane oxygenation ( 27 ).…”

“…Of the included studies, 16 were performed in the perioperative setting ( n = 1142 participants) (16–20, 23, 25, 26, 28, 30–32, 35, 36, 38, 39), six in the ICU ( n = 427 participants) (21, 27, 29, 33, 34, 37), one in the emergency department (ED; n = 90 participants) (24), and one in healthy volunteers ( n = 14 participants) (22). Five studies involved pediatric patients ( n = 298 participants) (16, 17, 25, 38, 39), whereas the remainder focused on adult participants. Volumes of study fluid received ranged from 380 mL (17) to 19,626 mL (37) (median, 2,000 mL and interquartile range, 2,812.5 mL).…”

“…The duration of study fluid administration also varied widely from 1 hour (29) to 5 days (37). Most studies ( n = 19) reported only short-term metabolic outcomes (16–22, 24–27, 29–32, 34, 37–39), while a few ( n = 5) reported longer term clinical outcomes (23, 28, 33, 35, 36). Six studies were available as abstract only (21, 25, 27, 33, 34, 38).…”