The articles for the month feature 2 articles on the use of lactated ringers.

Dr. Ansell will discuss one article on its use in patients with sickle cell occlusive pain crisis and Dr. Gugino will discuss another on its use in pancreatitis, both at least suggesting that it may be a better choice in these disease processes than normal saline.

Lastly, Dr. Sealy will be discussing a systematic review on a very rare procedure performed in emergency medicine, the resuscitative hysterotomy.  Thus far in my career I've never performed this procedure, and I hope I never will have to.  You can imagine there are not a lot of papers covering such a rare event, but hopefully this article discusses the best evidence for the procedure that is available. 

Ansell: Alwang AK, Law AC, Klings ES, Cohen RT, Bosch NA. Lactated Ringer vs Normal Saline Solution During Sickle Cell Vaso-Occlusive Episodes. JAMA Intern Med. 2024 Nov 1;184(11):1365-1372. doi: 10.1001/jamainternmed.2024.4428. PMID: 39250114; PMCID: PMC11385329. Summary

Gugino: Lee PJ, Culp S, Kamal A, Paragomi P, Pothoulakis I, Talukdar R, Kochhar R, Goenka MK, Gulla A, Gonzales J, Stevens T, Barbu S, Nawaz H, Gutierrez S, Zarnescu N, Capurso G, Easler J, Triantafyllou K, Ocampo C, de-Madaria E, Wu B, Hart PA, Akshintala VS, Singh VK, Bischof J, Buxbaum J, Pelaez M, Papachristou GI. Lactated Ringers Use in the First 24 Hours of Hospitalization Is Associated With Improved Outcomes in 999 Patients With Acute Pancreatitis. Am J Gastroenterol. 2023 Dec 1;118(12):2258-2266. doi: 10.14309/ajg.0000000000002391. Epub 2023 Jul 10. PMID: 37428139. Summary

Sealy: Leech C, Nutbeam T, Chu J, Knight M, Hinshaw K, Appleyard TL, Cowan S, Couper K, Yeung J. Maternal and neonatal outcomes following resuscitative hysterotomy for out of hospital cardiac arrest: A systematic review. Resuscitation. 2025 Feb;207:110479. doi: 10.1016/j.resuscitation.2024.110479. Epub 2024 Dec 29. PMID: 39736393. Summary