Limitations of Lactated Ringer's Solution in Massive Fluid Replacement

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Abstract
Extracellular fluid volume was maintained by administration of 14 liters whole blood, 28 liters lactated Ringer's solution, and 2 liters of dextran 70 in a patient suffering severe hemorrhage (25 liters) during a 4 1/2-hour decompressive cervical laminectomy. Lactated Ringer's solution proved advantageous as a supplement to the whole blood because of its ready availability, modest cost and freedom from hepatitis virus. However, determinations of the hematocrit value and total serum protein level demonstrated the limitation of lactated Ringer's solution in supplying colloid for total volume replacement.

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