From the Research
Lactated Ringer's solution can be safely used in patients with urostomies, as it provides balanced electrolyte replacement without causing significant metabolic disturbances, according to the most recent and highest quality study available 1.
Key Considerations
- The solution contains sodium (130 mEq/L), potassium (4 mEq/L), calcium (3 mEq/L), chloride (109 mEq/L), and lactate (28 mEq/L), which helps maintain electrolyte balance.
- Patients with urostomies often experience fluid and electrolyte losses, making Lactated Ringer's particularly suitable as it closely resembles normal plasma composition.
- Regular monitoring of fluid status, electrolytes, and urine output from the urostomy is essential during administration to ensure appropriate hydration and prevent complications.
Administration Guidelines
- The standard administration rate depends on the patient's clinical status, typically ranging from maintenance rates of 1-2 mL/kg/hr to higher rates for volume depletion.
- Unlike previous concerns with ileostomies where high lactate content might be problematic, urostomies divert urine rather than intestinal contents, so lactate metabolism is not significantly affected.
Supporting Evidence
- A study published in 2020 found that lactated Ringer's solution and normal saline had similar effects on postoperative complications in patients undergoing colorectal and orthopedic surgery 1.
- Another study published in 2019 discussed the care and management of patients with urostomies, highlighting the importance of proper fluid and electrolyte management 2.
- While older studies have raised concerns about the use of lactated Ringer's solution in certain patient populations, such as those with organic aciduria 3 or ileostomies 4, these concerns do not appear to be relevant to patients with urostomies.
- A more recent study published in 2022 discussed the effects of sodium administration on fluid balance and sodium balance in healthy individuals and surgical patients, but did not specifically address the use of lactated Ringer's solution in patients with urostomies 5.