The difference between Ringer and Sodium Lactate Ringer Last late autumn, while I was bedridden in the ward, I suddenly paused while watching the nurse change the infusion bag. Auntie, how did you change the sodium lactate Ringer today? "I pointed to the bag hanging up and asked. The nurse said while adjusting the drip rate, "Today's blood gas test is a bit sour, and the original Ringer's solution is not enough." This sentence made me stare at the two types of infusion bags at the bedside for several days - both used for fluid replacement, "Ringer" and "Sodium Lactate Ringer" are only three words short of "Sodium Lactate". Why is the doctor so particular when using them?
Later, I specifically searched through medical science books and shamelessly asked the on duty doctor to sort out the difference between the two. Actually, since I entered the hospital, I have often heard nurses say 'Bu Ling Ling', but the specific type of supplement depends on the patient's condition. Just like when my mom was hospitalized, she had been suffering from acute gastroenteritis for three days and her blood pressure was a bit low. The doctor prescribed regular Ringer's solution. The nurse said this is a "balanced salt" that can quickly replenish water and electrolytes such as sodium, potassium, and calcium. I specifically checked the ingredients on the bag at that time: there are 8.6 grams of sodium chloride, 0.3 grams of potassium chloride, and 0.33 grams of calcium chloride per 1000ml. It sounds like mixing the most basic minerals in the body into water in proportion, like watering crops with "nutrient water" that first moistens the dehydrated "dry fields".
On the fifth day of stay, the uncle in the same ward returned from abdominal surgery with the infusion bag clearly labeled "Sodium Lactate Ringer Injection". I leaned in to look at the ingredients and found that in addition to the regular Ringer's sodium chloride, potassium chloride, and calcium chloride, there were also 3.1 grams of sodium lactate. *The doctor said that the extra sodium lactate is the key. Just like the seasoning added when cooking soup, it may seem like a small amount, but the taste can be very different. Originally, our bodies produce metabolic waste every day, including acidic substances. Ordinary people can regulate acid-base balance on their own, but for someone like Uncle who has just undergone major surgery, their body has a strong stress response, produces a lot of acid, and has weak acid excretion ability. At this time, ordinary Ringer's solution can only replenish electrolytes and cannot help "neutralize acid". Sodium lactate enters the body and turns into sodium bicarbonate in the liver - an important "alkaline buffer" in the body that can absorb excess acid like a sponge, preventing the blood from becoming too acidic.
My mom was wondering at the time, "Is it better to use sodium lactate Ringer for all fluid tonics?" The doctor shook his head with a smile and said, "It's like having a separate meal - eating hot pot with ice cold cola is comfortable, but you can't add sweetness casually when drinking traditional Chinese medicine. Because of its simple ingredients, ordinary Ringer's liquid, like porridge, is suitable for most situations requiring rapid fluid replacement, such as diarrhea, slight dehydration, and excessive sweating after exercise. But it does not have the ability to "neutralize acid". If the patient already has a tendency towards acidosis (such as severe infection, prolonged shock), or poor liver function (sodium lactate requires liver metabolism), using sodium lactate may actually increase the burden. Just like when my mother was first admitted to the hospital, she was only dehydrated, so using a regular Ringer is safer at this time; After the surgery, the uncle's body is in a "high metabolism" state, and too much acid cannot be excreted. Sodium lactate Ringer is like "timely rain".
One day, I accompanied Dr. X on a ward round and coincidentally encountered a patient with intestinal obstruction. The nurse held up sodium lactate Ringer's solution and asked, "Can this patient use it?" The doctor looked at the examination sheet and said, "His blood gas analysis is normal, let's switch to regular Ringer's solution first." I then understood that choosing a liquid by a doctor is like a chef's side dish - the taste of the dish should match the heat and ingredients. Although sodium lactate Ringer has the ability to neutralize acid, it is not omnipotent. I remember one time I was at the nurse station listening to their discussion about an old patient who had been using Sodium Lactate Ringer for a long time. However, after checking his blood gas, it was found to be slightly alkaline. Later, he switched back to regular Ringer and recovered. You see, even good things can still have problems if used too much or incorrectly.

Looking back now, the scene of staring blankly at two types of infusion bags in the ward that day was quite interesting. The "difference" in medicine was never just words on paper, but rather a single page of a patient's temperature, heartbeat, and laboratory tests. Just like when my mother was discharged from the hospital, the doctor specifically said, "If you encounter dehydration again in the future, drink oral rehydration salts first. The ingredients in those salts are similar to Ringer's solution. But if the situation is serious, don't blindly replenish fluids yourself. You need to let the doctor see if it's just a lack of water or if the acid-base balance in the body is also disrupted - Ringer or Sodium Lactate Ringer is very different at this time." You may ask, how do ordinary people remember these differences? Actually, just remember two key words: ordinary Ringer's solution is "basic replenishment", suitable for simple hydration and electrolytes; Sodium lactate Ringer's solution is a "fluid supplement with buffering function" that is suitable for situations where there is too much acid in the body and assistance is needed to neutralize it. Just like a toolbox at home, a screwdriver is used to tighten screws, a wrench is used to tighten nuts, each with its own purpose.
Every time I pass by the hospital now, I think of the two liquids in the ward that have similar colors but different uses. Their differences are hidden in those few grams of sodium lactate, in the doctor's brow as he looks through the medical records, and even more so in each patient's gradually recovering smile. This is probably the most authentic form of medicine - there is no such thing as' best ', only' most suitable '. The difference between Ringer and Sodium Lactate Ringer, ultimately, is that doctors choose the most suitable "key" based on the patient's condition to open the door to rehabilitation.