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[Ringer solution: osmolarity and composition revisited].

M G Kees1, H Schlotterbeck, R Passemard

  • 1Département d'anesthésie-réanimation, hôpital de Hautepierre, 67000 Strasbourg, France.

Annales Francaises D'Anesthesie Et De Reanimation
|May 7, 2005
PubMed
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Ringer solution from Maco Pharma was mislabeled as isotonic. This hypotonic fluid poses risks, especially for patients sensitive to free water infusion during anesthesia and intensive care.

Area of Science:

  • Medical Science
  • Pharmacology
  • Intensive Care Medicine

Background:

  • Ringer solution, a common crystalloid fluid in anesthesia and intensive care, exhibits manufacturer-dependent composition variations.
  • Accurate knowledge of electrolyte content and fluid characteristics is crucial before administration.

Purpose of the Study:

  • To highlight discrepancies in the osmolarity and tonicity information provided by the manufacturer for a specific Ringer solution (Ringer Maco Pharma).
  • To alert healthcare professionals to the potential dangers of using this mislabeled hypotonic fluid.

Main Methods:

  • Theoretical osmolarity calculation based on electrolyte content.
  • Measurement of the fluid's osmolality.
  • Comparison of calculated and measured values against manufacturer-stated values.

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Main Results:

  • The Ringer Maco Pharma solution was found to be hypotonic, with a theoretical osmolarity of 221.4 mOsm/l and measured osmolality of approximately 208 mmol/kg.
  • This contradicts the manufacturer's claim of isotonicity and an osmolarity of 276.8 mOsm/l.

Conclusions:

  • The manufacturer's information regarding tonicity and osmolarity for Ringer Maco Pharma was inaccurate.
  • Administration of this hypotonic fluid can be dangerous for patients with conditions poorly tolerating free water infusion.