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Ringer's acetate is a **balanced isotonic crystalloid intravenous fluid** used for extracellular-volume replacement and fluid resuscitation. It contains water, electrolytes and an acetate buffer; exact ionic composition varies by manufacturer and market. Sodium and accompanying electrolytes support restoration of extracellular fluid and electrolyte deficits, while acetate is metabolized to bicarbonate equivalents and can provide an alkalinizing buffer effect. In the 6S randomized phase 3 trial in adults with severe sepsis, Ringer's acetate was the balanced-crystalloid comparator to hydroxyethyl starch 130/0.42; the trial found lower 90-day mortality and less renal-replacement therapy in the Ringer's acetate group than in the hydroxyethyl-starch group.
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