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Effects of Lactated Ringer’s Solutions on Human Leukocytes

Koustova, Elena PhD; Stanton, Kathleen MS; Gushchin, Vadim MD; Alam, Hasan B. MD; Stegalkina, Svetlana MS; Rhee, Peter M. MD, MPH

The Journal of Trauma: Injury, Infection, and Critical Care: May 2002 - Volume 52 - Issue 5 - p 872-878
Annual Meeting Articles

Background  The standard lactated Ringer’s (LR) solution contains racemic lactate, an equal mixture of d(−)- and l(+)-isomers. The aim of this study was to investigate whether racemic LR solution (containing both isomers, dl-LR) differs from LR containing l-isomer only (l-LR).

Methods  Blood from 20 volunteers was incubated for 30 minutes with lactated Ringer’s solutions containing the dl- or l-form of lactate, Hank’s balanced salt solu-tion, normal saline, and ketone Ringer’s (lactate replaced with ketone bodies). Neutrophil “oxidative burst” was measured using flow cytometry. Gene expression of 23 genes associated with leukocyte function was determined with cDNA array technique. The arraying procedure was repeated four times to obtain four sets of data.

Results  Compared with the l-LR and ketone Ringer’s, dl-LR causes an increased production of reactive oxygen spe-cies by neutrophils and affects expression of leukocyte genes known to be involved in inflammation, cell migration, and apoptosis.

Conclusion  Lactated Ringer’s solution in commonly used formulation (racemic mixture, dl-LR) influences neutrophil function and leukocyte gene expression.

From the Department of Surgery, Uniformed Services University of the Health Sciences (E.K., K.S., V.G., H.B.A., S.S., P.M.R.), Bethesda, Maryland, and Department of Surgery, Washington Hospital Center (V.G., H.B.A., P.M.R.), Washington, D.C.

Submitted for publication October 10, 2001.

Accepted for publication November 30, 2001.

Supported by Office of Naval Research grant MDA 905-99-1-0022.

The opinions and assertions contained herein are the private ones of the authors and are not to be construed as official or reflecting the views of the Department of Defense at large. This manuscript was prepared by United States Government employees and, therefore, cannot be copyrighted and may be copied with restriction.

This work was scheduled for presentation at the 61st Annual Meeting of the American Association for the Surgery of Trauma, which was canceled because of the terrorist attacks of September 11, 2001.

Address for reprints: Elena Koustova, PhD, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD 20814; email:

© 2002 Lippincott Williams & Wilkins, Inc.