Ringer's solution is a solution of several salts dissolved in water for the purpose of creating an isotonic solution relative to the body fluids of an animal. Ringer's solution typically contains sodium chloride, potassium chloride, calcium chloride and sodium bicarbonate, with the last used to balance the pH. Other additions can include chemical fuel sources for cells, including ATP and dextrose, as well as antibiotics and antifungals.
Ringer's solution typically contains NaCl, KCl, CaCl2 and NaHCO3, sometimes with other minerals such as MgCl2, dissolved in distilled water. The precise proportions of these vary from species to species, particularly between marine osmoconformers and osmoregulators. [1] [2]
Ringer's solution is frequently administered to human and veterinary patients for intravenous or subcutaneous hydration and to expand the vascular compartment in hypovolemia. It is also use in in vitro experiments on organs or tissues, such as in vitro muscle testing. [3] [4] [5] [6] The precise mix of ions can vary depending upon the taxon, with different recipes for birds, mammals, freshwater fish, marine fish, etc.
Ringers solution may also be used for therapeutic purposes, such as arthroscopic lavage in the case of septic arthritis. [7] [8] It is used clinically as an intravenous infusion for replacing extracellular fluid losses and restoring chemical balances when treating isotonic dehydration. [9]
Ringer's solution is named after Sydney Ringer, who in 1882–1885 determined that a solution perfusing a frog's heart must contain sodium, potassium and calcium salts in a definite proportion if the heart is to be kept beating for long. [10] [11] This solution was adjusted further in the 1930s by Alexis Hartmann, who added sodium lactate to form Ringer's lactate solution. [12]
Potassium is a chemical element with the symbol K and atomic number 19. Potassium is a silvery-white metal that is soft enough to be cut with a knife with little force. Potassium metal reacts rapidly with atmospheric oxygen to form flaky white potassium peroxide in only seconds of exposure. It was first isolated from potash, the ashes of plants, from which its name derives. In the periodic table, potassium is one of the alkali metals, all of which have a single valence electron in the outer electron shell, that is easily removed to create an ion with a positive charge – a cation, that combines with anions to form salts. Potassium in nature occurs only in ionic salts. Elemental potassium reacts vigorously with water, generating sufficient heat to ignite hydrogen emitted in the reaction, and burning with a lilac-colored flame. It is found dissolved in sea water, and occurs in many minerals such as orthoclase, a common constituent of granites and other igneous rocks.
In chemistry, a salt is a chemical compound consisting of an ionic assembly of positively charged cations and negatively charged anions, which results in a compound with no net electric charge. A common example is table salt, with positively charged sodium ions and negatively charged chloride ions.
An electrolyte is a medium containing ions that is electrically conducting through the movement of ions, but not conducting electrons. This includes most soluble salts, acids, and bases dissolved in a polar solvent, such as water. Upon dissolving, the substance separates into cations and anions, which disperse uniformly throughout the solvent. Solid-state electrolytes also exist. In medicine and sometimes in chemistry, the term electrolyte refers to the substance that is dissolved.
The chloride ion is the anion Cl−. It is formed when the element chlorine gains an electron or when a compound such as hydrogen chloride is dissolved in water or other polar solvents. Chloride salts such as sodium chloride are often very soluble in water. It is an essential electrolyte located in all body fluids responsible for maintaining acid/base balance, transmitting nerve impulses and regulating liquid flow in and out of cells. Less frequently, the word chloride may also form part of the "common" name of chemical compounds in which one or more chlorine atoms are covalently bonded. For example, methyl chloride, with the standard name chloromethane is an organic compound with a covalent C−Cl bond in which the chlorine is not an anion.
Sodium chloride, commonly known as salt, is an ionic compound with the chemical formula NaCl, representing a 1:1 ratio of sodium and chloride ions. With molar masses of 22.99 and 35.45 g/mol respectively, 100 g of NaCl contains 39.34 g Na and 60.66 g Cl. Sodium chloride is the salt most responsible for the salinity of seawater and of the extracellular fluid of many multicellular organisms. In its edible form of table salt, it is commonly used as a condiment and food preservative. Large quantities of sodium chloride are used in many industrial processes, and it is a major source of sodium and chlorine compounds used as feedstocks for further chemical syntheses. A second major application of sodium chloride is de-icing of roadways in sub-freezing weather.
Intravenous therapy is a medical technique that administers fluids, medications and nutrients directly into a person's vein. The intravenous route of administration is commonly used for rehydration or to provide nutrients for those who cannot, or will not—due to reduced mental states or otherwise—consume food or water by mouth. It may also be used to administer medications or other medical therapy such as blood products or electrolytes to correct electrolyte imbalances. Attempts at providing intravenous therapy have been recorded as early as the 1400s, but the practice did not become widespread until the 1900s after the development of techniques for safe, effective use.
Fluid replacement or fluid resuscitation is the medical practice of replenishing bodily fluid lost through sweating, bleeding, fluid shifts or other pathologic processes. Fluids can be replaced with oral rehydration therapy (drinking), intravenous therapy, rectally such as with a Murphy drip, or by hypodermoclysis, the direct injection of fluid into the subcutaneous tissue. Fluids administered by the oral and hypodermic routes are absorbed more slowly than those given intravenously.
Membrane potential is the difference in electric potential between the interior and the exterior of a biological cell. That is, there is a difference in the energy required for electric charges to move from the internal to exterior cellular environments and vice versa, as long as there is no acquisition of kinetic energy or the production of radiation. The concentration gradients of the charges directly determine this energy requirement. For the exterior of the cell, typical values of membrane potential, normally given in units of millivolts and denoted as mV, range from –80 mV to –40 mV.
Loop diuretics are diuretics that act on the Na-K-Cl cotransporter along the thick ascending limb of the loop of Henle in the kidney. They are primarily used in medicine to treat hypertension and edema often due to congestive heart failure or chronic kidney disease. While thiazide diuretics are more effective in patients with normal kidney function, loop diuretics are more effective in patients with impaired kidney function.
Saline is a mixture of sodium chloride (salt) and water and has a number of uses in medicine. It is used to clean wounds, remove and store contact lenses, and help with dry eyes. By injection into a vein, it is used to treat dehydration, such as from gastroenteritis and diabetic ketoacidosis.
Ringer's lactate solution (RL), also known as sodium lactate solution,Lactated Ringer’s, and Hartmann's solution, is a mixture of sodium chloride, sodium lactate, potassium chloride, and calcium chloride in water. It is used for replacing fluids and electrolytes in those who have low blood volume or low blood pressure. It may also be used to treat metabolic acidosis and to wash the eye following a chemical burn. It is given by intravenous infusion or applied to the affected area.
Phosphate-buffered saline is a buffer solution commonly used in biological research. It is a water-based salt solution containing disodium hydrogen phosphate, sodium chloride and, in some formulations, potassium chloride and potassium dihydrogen phosphate. The buffer helps to maintain a constant pH. The osmolarity and ion concentrations of the solutions match those of the human body (isotonic).
Temocillin is a β-lactamase-resistant penicillin introduced by Beecham, marketed by Eumedica Pharmaceuticals as Negaban. It is used primarily for the treatment of multiple drug-resistant, Gram-negative bacteria.
It is a 6-methoxy penicillin; it is also a carboxypenicillin.
Hypokalemic periodic paralysis (hypoKPP), also known as familial hypokalemic periodic paralysis (FHPP), is a rare, autosomal dominant channelopathy characterized by muscle weakness or paralysis when there is a fall in potassium levels in the blood. In individuals with this mutation, attacks sometimes begin in adolescence and most commonly occur with individual triggers such as rest after strenuous exercise, high carbohydrate meals, meals with high sodium content, sudden changes in temperature, and even excitement, noise, flashing lights, cold temperatures and stress. Weakness may be mild and limited to certain muscle groups, or more severe full-body paralysis. During an attack, reflexes may be decreased or absent. Attacks may last for a few hours or persist for several days. Recovery is usually sudden when it occurs, due to release of potassium from swollen muscles as they recover. Some patients may fall into an abortive attack or develop chronic muscle weakness later in life.
Calcium gluconate is a mineral supplement and medication. As a medication it is used by injection into a vein to treat low blood calcium, high blood potassium, and magnesium toxicity. Supplementation is generally only required when there is not enough calcium in the diet. Supplementation may be done to treat or prevent osteoporosis or rickets. It can also be taken by mouth but is not recommended for injection into a muscle.
Sydney Ringer FRS was a British clinician, physiologist and pharmacologist, best known for inventing Ringer's solution. He was born in 1835 in Norwich, England and died following a stroke in 1910 in Lastingham, Yorkshire, England. His gravestone and some other records report 1835 for his birth, some census records and other documents suggest 1836, but his baptismal record at St Mary's Baptist Chapel confirms this was 1835.
The salt gland is an organ for excreting excess salts. It is found in the cartilaginous fishes subclass elasmobranchii, seabirds, and some reptiles. Salt glands can be found in the rectum of sharks. Birds and reptiles have salt glands located in or on the skull, usually in the eyes, nose, or mouth. These glands are lobed containing many secretory tubules which radiate outward from the excretory canal at the center. Secretory tubules are lined with a single layer of epithelial cells. The diameter and length of these glands vary depending on the salt uptake of the species.
A volume expander is a type of intravenous therapy that has the function of providing volume for the circulatory system. It may be used for fluid replacement or during surgery to prevent nausea and vomiting after surgery.
A balanced salt solution (BSS) is a solution made to a physiological pH and isotonic salt concentration. Solutions most commonly include sodium, potassium, calcium, magnesium, and chloride. Balanced salt solutions are used for washing tissues and cells and are usually combined with other agents to treat the tissues and cells. They provide the cells with water and inorganic ions, while maintaining a physiological pH and osmotic pressure.
Earle's balanced salt solution is an isotonic saline solution (or balanced salt solution) formulated by W.R. Earle in 1943. It contains sodium chloride, potassium chloride, calcium chloride, magnesium sulfate, sodium dihydrogen phosphate, sodium bicarbonate and dextrose (glucose). It is intended to be used in 5% CO2 atmosphere. It is a base of many cell culture media.
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