Which solution should not be used in the treatment of hypothermia due to liver concerns?

Lactated Ringer's (LR) solution contains lactate, which the liver metabolizes to bicarbonate. In cases of hypothermia, particularly when there are concerns about liver function or potential failure, the use of lactated Ringer's could potentially exacerbate existing liver issues or lead to complications. The liver’s impaired ability to metabolize lactate may lead to an accumulation of lactic acid, which can worsen acidosis and result in further complications in patients with compromised liver function.

In contrast, other solutions such as normal saline and 0.9% sodium chloride do not contain lactate and do not pose this risk. Dextrose solutions are also safe regarding liver concerns, but they serve different therapeutic purposes, particularly in addressing hypoglycemia rather than fluid resuscitation in hypothermia. Therefore, selecting the right intravenous solution in this context is critical to avoid complications associated with compromised liver function while effectively managing the patient's hypothermia.