Resuscitation with lactated Ringer's solution after hemorrhage: Lack of cardiac toxicity

Keith Delman, Sayeed K. Malek, Samuel Bundz, Naji N. Abumrad, Charles H. Lang, Patricia E. Molina

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

The toxicity of D-lactate has been recognized for almost 30 years. This compound is found in the racemic mixture of lactated Ringer's solutions routinely used for peritoneal dialysis and the resuscitation of trauma victims. The current study was designed to investigate whether toxicity occurred at the D-lactate concentrations achieved during hemorrhage resuscitation with racemic lactated Ringer's solution. Conscious unrestrained male Sprague-Dawley rats (n = 24) were monitored for electrocardiographic abnormalities while undergoing hemorrhage and subsequent resuscitation with either L-lactated, D-lactated, or racemic lactated Ringer's solution. The rats infused with D-lactate showed significant toxicity as evidenced by bradycardia, premature ventricular contractions, and ventricular fibrillation. No such alterations were observed in the animals resuscitated with L-lactate or racemic solutions. Resuscitation with the racemic lactate mixture increased the D-lactate concentrations in the blood, but was not associated with overt changes in cardiac rhythm. The infusion of the different resuscitation fluids produced few significant differences in acid-base status of hemorrhaged rats. These findings indicate that although toxicity may be achieved with a Ringer's solution containing only D-lactate, resuscitation using the racemic mixture does not achieve D-lactate concentrations high enough to be detrimental to the animal.

Original languageEnglish (US)
Pages (from-to)298-303
Number of pages6
JournalShock
Volume5
Issue number4
StatePublished - Apr 1 1996

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Resuscitation
Lactic Acid
Hemorrhage
Ventricular Premature Complexes
Ringer's solution
Ringer's lactate
Cardiotoxicity
Peritoneal Dialysis
Ventricular Fibrillation
Bradycardia
Sprague Dawley Rats
Acids
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Delman, K., Malek, S. K., Bundz, S., Abumrad, N. N., Lang, C. H., & Molina, P. E. (1996). Resuscitation with lactated Ringer's solution after hemorrhage: Lack of cardiac toxicity. Shock, 5(4), 298-303.
Delman, Keith ; Malek, Sayeed K. ; Bundz, Samuel ; Abumrad, Naji N. ; Lang, Charles H. ; Molina, Patricia E. / Resuscitation with lactated Ringer's solution after hemorrhage : Lack of cardiac toxicity. In: Shock. 1996 ; Vol. 5, No. 4. pp. 298-303.
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Delman, K, Malek, SK, Bundz, S, Abumrad, NN, Lang, CH & Molina, PE 1996, 'Resuscitation with lactated Ringer's solution after hemorrhage: Lack of cardiac toxicity', Shock, vol. 5, no. 4, pp. 298-303.

Resuscitation with lactated Ringer's solution after hemorrhage : Lack of cardiac toxicity. / Delman, Keith; Malek, Sayeed K.; Bundz, Samuel; Abumrad, Naji N.; Lang, Charles H.; Molina, Patricia E.

In: Shock, Vol. 5, No. 4, 01.04.1996, p. 298-303.

Research output: Contribution to journalArticle

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N2 - The toxicity of D-lactate has been recognized for almost 30 years. This compound is found in the racemic mixture of lactated Ringer's solutions routinely used for peritoneal dialysis and the resuscitation of trauma victims. The current study was designed to investigate whether toxicity occurred at the D-lactate concentrations achieved during hemorrhage resuscitation with racemic lactated Ringer's solution. Conscious unrestrained male Sprague-Dawley rats (n = 24) were monitored for electrocardiographic abnormalities while undergoing hemorrhage and subsequent resuscitation with either L-lactated, D-lactated, or racemic lactated Ringer's solution. The rats infused with D-lactate showed significant toxicity as evidenced by bradycardia, premature ventricular contractions, and ventricular fibrillation. No such alterations were observed in the animals resuscitated with L-lactate or racemic solutions. Resuscitation with the racemic lactate mixture increased the D-lactate concentrations in the blood, but was not associated with overt changes in cardiac rhythm. The infusion of the different resuscitation fluids produced few significant differences in acid-base status of hemorrhaged rats. These findings indicate that although toxicity may be achieved with a Ringer's solution containing only D-lactate, resuscitation using the racemic mixture does not achieve D-lactate concentrations high enough to be detrimental to the animal.

AB - The toxicity of D-lactate has been recognized for almost 30 years. This compound is found in the racemic mixture of lactated Ringer's solutions routinely used for peritoneal dialysis and the resuscitation of trauma victims. The current study was designed to investigate whether toxicity occurred at the D-lactate concentrations achieved during hemorrhage resuscitation with racemic lactated Ringer's solution. Conscious unrestrained male Sprague-Dawley rats (n = 24) were monitored for electrocardiographic abnormalities while undergoing hemorrhage and subsequent resuscitation with either L-lactated, D-lactated, or racemic lactated Ringer's solution. The rats infused with D-lactate showed significant toxicity as evidenced by bradycardia, premature ventricular contractions, and ventricular fibrillation. No such alterations were observed in the animals resuscitated with L-lactate or racemic solutions. Resuscitation with the racemic lactate mixture increased the D-lactate concentrations in the blood, but was not associated with overt changes in cardiac rhythm. The infusion of the different resuscitation fluids produced few significant differences in acid-base status of hemorrhaged rats. These findings indicate that although toxicity may be achieved with a Ringer's solution containing only D-lactate, resuscitation using the racemic mixture does not achieve D-lactate concentrations high enough to be detrimental to the animal.

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Delman K, Malek SK, Bundz S, Abumrad NN, Lang CH, Molina PE. Resuscitation with lactated Ringer's solution after hemorrhage: Lack of cardiac toxicity. Shock. 1996 Apr 1;5(4):298-303.