Glucose Content of Plain Lactated Ringer's Solution
Plain Lactated Ringer's solution contains 0 mmol/L (0 g/dL) of glucose. 1
Composition Details
Standard Lactated Ringer's solution is a glucose-free crystalloid that contains sodium 130 mmol/L, chloride 109 mmol/L, potassium 4 mmol/L, calcium 1.4 mmol/L, and lactate 28 mmol/L. 1
The osmolarity of plain Lactated Ringer's is approximately 273-277 mOsm/L, making it slightly hypotonic compared to plasma (275-295 mOsm/L). 1, 2
The absence of glucose distinguishes plain Lactated Ringer's from dextrose-containing variants such as D5LR (5% dextrose in Lactated Ringer's, which contains 278 mmol/L glucose) or lower-concentration formulations. 1
Clinical Implications of Glucose-Free Formulation
In pediatric patients and infants requiring maintenance IV fluids, plain Lactated Ringer's without dextrose should not be used alone because children have limited glycogen stores and are at high risk for hypoglycemia during fasting states. 3
For perioperative pediatric fluid management, Lactated Ringer's with 0.9-1% dextrose (approximately 50-55 mmol/L glucose) is recommended to prevent both hypoglycemia and hyperglycemia. 4
In adult surgical patients who have fasted preoperatively, large volumes of plain Lactated Ringer's solution have minimal effect on blood glucose levels and do not cause hypoglycemia, making it an appropriate choice for resuscitation and replacement in healthy adults. 5
Modified Formulations
Research formulations of Lactated Ringer's containing 0.7% glucose (approximately 39 mmol/L) or 1.4% glucose (approximately 78 mmol/L) have been studied in surgical patients to maintain normoglycemia during anesthesia, but these are not standard "plain" Lactated Ringer's. 6, 7
When glucose supplementation is needed alongside Lactated Ringer's resuscitation, it should be provided either as a separate dextrose-containing solution or by using a pre-mixed formulation (e.g., D5LR), rather than relying on plain Lactated Ringer's. 8