A 5-year-old with septic shock requires large-volume fluid resuscitation. The intensivist chooses Ringer's lactate over 0.9% normal saline. What is the primary physiological advantage of Ringer's lactate in this setting?
- A Contains lactate buffer and lower chloride load reducing hyperchloremic acidosis ✓
- B Higher sodium content prevents hyponatremia
- C Contains dextrose preventing hypoglycemia
- D Higher osmolarity maintains intravascular volume longer
Correct answer: A. Contains lactate buffer and lower chloride load reducing hyperchloremic acidosis
Explanation
Ringer's lactate contains 130 mEq/L sodium and 28 mEq/L lactate (metabolized to bicarbonate), with lower chloride (109 mEq/L) than normal saline (154 mEq/L). Large-volume normal saline causes hyperchloremic metabolic acidosis, which may worsen kidney injury and hemodynamic status. RL better approximates plasma electrolyte composition. It does not contain dextrose and has slightly lower osmolarity than NS.
Reference: Bailey and Love's Short Practice of Surgery, 28th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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