An estimated 4 million hospitalized patients recieve IV fluids annually in the United States. Authors of a new study on saline say a switch to so-called balanced fluids could save thousands of lives a year
The investigations included 28,000 patients at Vanderbilt University who were given IVs of saline or an adjusted liquid.
Kellum had no role in the studies, which were discussed Tuesday at a critical care conference in San Antonio and published by the New England Journal of Medicine.
Using a different kind of intravenous fluid instead of the saline generally used for IV drips in hospitals will reduce the risks of death or kidney damage, two studies found.
The results have prompted a change in practice toward using primarily balanced fluids instead of saline at Vanderbilt University Medical Center.
IVs are a standout amongst the most widely recognized things in medicinal services. They were assigned to receive saline or balanced fluids if they required intravenous fluid between June 2015 and April 2017.
The incidence of major adverse events were all lower in the balanced crystalloids group vs saline group: death (1.4% vs. 1.6%), new renal-replacement therapy (0.3% vs. 0.5%) and final serum creatinine ≥200% (3.3% vs 4.5%).
Saline - salt dissolved in water - has been the most widely used fluid in the US for more than a century even as evidence has emerged that it can harm kidneys, especially when used a lot.
The difference could mean 50,000 to 70,000 fewer deaths and 100,000 fewer cases of kidney failure each year in the US, researchers estimate.
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The results showed no difference in the number of hospital-free days (primary outcome) between either group (median 25 days in each group, odds ratio with balanced crystalloids, 0.98; 95% CI: 0.92 to 1.04; P=0.41).
"Doctors have been giving patients IV fluids for more than 100 years and saline has been the most common fluid patients have been getting", said study author Dr. Todd Rice, an associate professor of Medicine.
"Our results suggest that using primarily balanced fluids should prevent death or severe kidney dysfunction for hundreds of Vanderbilt patients and tens of thousands of patients across the country each year", said study author Matthew Semler, MD, MSc, assistant professor of Medicine at Vanderbilt University School of Medicine.
The liquids set you back concerning the exact same- a buck or more each IV- and also several distributors make both kinds, so switching over must not be hard or costly, medical professionals stated.
"The choice about which one to use mostly comes down to how physicians are trained", he said.
Saline, used in medicine for more than a century, contains high concentrations of sodium chloride, which is similar to table salt.
Critical care specialist Dr. Timothy Buchman, of Emory Healthcare in Atlanta, who was not involved with the study, expects more doctors to switch to fluids.
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