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LR vs Saline infusions


Pistol
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I am wondering how many of you benefit from Lactated Ringers more than Saline infusions? My autonomic specialist claims that there is not enough data to tell if anything other than NSS ( Saline solution ) helps POTS patients. However - I have found to be A LOT BETTER for longer times after LR infusions rather than NSS. With NSS I would get headaches, fluid retention and high BP. Oddly enough - when I need fluids my BP is HIGH and when I get LR my BP goes down. And CP, palpitations and headaches go away. With NSS I do not have that immediate relief of symptoms. AND - when I get bad I start peeing very much but when I get LR I do not pee all the IV fluids out right away. @Bluebonnet08 - you mentioned in one of you posts that you also benefit from LR. Any Input? ( Hope you continue to be better? )

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I seem to do better with the lactated ringers (less side effects).  The OB was insistent that I receive the LR while pregnant.  I've done a little research on it and it seems like in general, the lactated ringers are somewhat safer. They are actually doing a clinical study on this right now as well that I am following.  I think there is a certain medical condition where saline IVs are preferred, but I don't remember what it was, I'll have to read up on it.    I am getting 3 bags of LR a week now post-partum and it's helped a lot.  It took the bradycardia away and so far I've felt much better than I did last post-partum.  

https://www.medpagetoday.com/meetingcoverage/sccm/71414

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Also wanted to add that how quickly it's run makes a difference for me.  I get quite symptomatic if it's run too fast.  We have a Hydration Clinic that is about 5 minutes from our house where I can just walk in and get IVs as needed.  They will also come to our home.  It's been a lifesaver with this condition!  They see a lot of people with POTS and other health conditions. 

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@Bluebonnet08 thank you soo much for sharing this!! I used to get NSS infusions but when there was a shortage of NSS due to the hurricane in PR they gave me LR. I really did so much better on it, so now they give me LR when I get bad. I do not tolerate fluids given fast, so they give me 4L LR over 24 hours and it totally turns me around, it is like a button gets turned off. I hope you continue to feel better and I wish you well!! 

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  • 4 years later...
On 6/15/2018 at 7:35 PM, Pistol said:

@Bluebonnet08 thank you soo much for sharing this!! I used to get NSS infusions but when there was a shortage of NSS due to the hurricane in PR they gave me LR. I really did so much better on it, so now they give me LR when I get bad. I do not tolerate fluids given fast, so they give me 4L LR over 24 hours and it totally turns me around, it is like a button gets turned off. I hope you continue to feel better and I wish you well!! 

Hi again Pistol! I just recently started a trial of NS infusions twice a week (1L run for about 2 hours). I noticed the effect was quite temporary (during the infusion my HR normalized, almost reaching 60s, and my BP, which runs low and normally has a pretty narrow pulse pressure, looked almost normal!). Did you say that was true for you in your experience? Did you only switch to LR due to your experience in ER admissions? Additionally, how did you know to try running at a slower speed? I haven't experimented with that quite yet. I also realize I am fresh to this trial so I may be speaking prematurely!

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Hi @kimpotster they used LR instead of NSS when there was a temporary IV fluid shortage and that was what they had. And also during surgeries they used that instead of NSS. In both cases the effect of LR vs NSS was longer lasting. regarding length of infusion time: I used to have to wait to get an infusion until I was really bad ( bedridden and seizures or passing out when up ) and had to be admitted overnight for infusions. 3 liters over 24 hours were so much better than 1 liter over one or 2 hours in ER, the effects lasted longer. the faster the infusions ran in the more I peed out, and I would swell up from fluid not absorbed into the blood stream. Than we experimented with 1 liter over 8 hours and that was perfect, but it was almost impossible to arrange realistically as outpatient. Now I get 1 liter twice a week on a preventative basis, running LR over about 4 hours. This has been a game changer for me!

Other members here had similar experiences, but we are all different, and our circumstances of how we can get fluids are different. 

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I do better with the LR so my doctors have me on 1 LR and 1 NSS twice a week, it would be 2 LR but my MCAS acts up and running slower is much better. 

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