SoylentNews is people
SoylentNews
Would it be wise for many hospitals to replace saline with balanced fluids for hospitalized patients? It appears so. Doing such a move might significantly reduce mortality and morbidity, according to Vanderbilt University Medical Center's Matthew W. Semler during a presentation at the annual meeting of the Society of Critical Care Medicine.
The study involved 28,000 patients at Vanderbilt University who were given either saline-based IV bags or balanced fluid variants. They found that for every 100 patients on balanced fluids, there was one fewer death or critical kidney damage. Yes, 1 percent doesn't seem a dramatic reduction — but when viewed at a grander scale, that could mean up to 70,000 fewer deaths and 100,000 fewer incidents of kidney problems annually in the United States.
(Score: 5, Informative) by khallow on Wednesday February 28 2018, @09:21PM (12 children)
Saline solution was used in the first place as a fluid replacement because it was balanced in terms of salinity. "Balanced fluids" are merely more balanced in that they preserve the salinity balance with a chemical makeup more like human plasma. Here's the money quote:
(Score: 5, Interesting) by Spook brat on Wednesday February 28 2018, @10:11PM (7 children)
Thanks for pointing out the medpagetoday article; that one from techtimes was awful.
I was surprised that this was an issue at all; the Army had it figured out long ago. Most units have an embedded "Combat Lifesaver", who isn't a medic but carries an aid bag and renders assistance when needed in addition to their normal duties. Combat Lifesavers are issued Lactated Ringer's solution exclusively, not normal saline.
I think there's a bit of institutional inertia going on here; doctors who were trained to use saline because it's compatible with blood transfusions are going to take the position of "no one ever got fired for
buying IBMgiving Normal Saline". Also, anything with sugar in it will change tonicity [yournursingtutor.com] over time as the body uses the sugars for energy, so it's not a fire-and-forget type of solution for replacing fluids.Kudos to the researchers ringing the alarm bell and waking up the doctors who are being lazy with their patients' care.
Travel the galaxy! Meet fascinating life forms... And kill them [schlockmercenary.com]
(Score: 1) by khallow on Wednesday February 28 2018, @10:52PM (1 child)
(Score: 2) by Spook brat on Thursday March 01 2018, @12:21PM
You were, just not from the one listed as "source" with the big hyperlink at the bottom of the article. I missed the underline on the word "according" in my first skim of the summary, and went for the mor obvious article at the end, with disappointing results.
Travel the galaxy! Meet fascinating life forms... And kill them [schlockmercenary.com]
(Score: 3, Informative) by frojack on Thursday March 01 2018, @01:02AM
Ringers predates saline in terms of preference. Somewhere the bean counters started practicing medicine.
Another article explains in more detail what constitutes balance: https://www.ncbi.nlm.nih.gov/pubmed/23743589 [nih.gov] and they are not so sure its yet a slam dunk.
No, you are mistaken. I've always had this sig.
(Score: 3, Interesting) by Azuma Hazuki on Thursday March 01 2018, @03:15AM (3 children)
Normal saline sure as hell will get someone fired if they give it in big doses to someone suffering from water toxicity (hyponatraemia). From what I've read, restoring the osmotic balance to "normal" too quickly causes damage to the cells of the brain stem. Scary, and not something I'd *ever* have suspected would happen. I wonder how they found this out...
I am "that girl" your mother warned you about...
(Score: 1) by khallow on Thursday March 01 2018, @04:12AM
The hard way, no doubt. Probably with "Ok, what did this guy die of?"
(Score: 0) by Anonymous Coward on Friday March 02 2018, @02:10AM (1 child)
As someone who was near death due to dehydration and was then quickly hydrated, do you remember where you heard that?
(Score: 2) by Azuma Hazuki on Friday March 02 2018, @03:08AM
This is the opposite problem: water poisoning, resulting in too little (hypo-) sodium (natr-) in the blood (-aemia).
I am "that girl" your mother warned you about...
(Score: 2) by mhajicek on Wednesday February 28 2018, @11:40PM (3 children)
If this study is correct, this change would save twice as many people in the US as are shot to death every year. Why aren't the MSM up in arms over this? This should be on the front page for weeks if lives are what's valued!
The spacelike surfaces of time foliations can have a cusp at the surface of discontinuity. - P. Hajicek
(Score: 2) by insanumingenium on Thursday March 01 2018, @12:07AM
Because no one gets all worked up over pool gates, natural and state disasters are attention grabbing.
(Score: 2) by Runaway1956 on Thursday March 01 2018, @02:50PM (1 child)
So, uhhhh, twice as many people as are shot? Cool - we can quit worrying so much about school shooters?
And, man, don't bother with a serious reply - that's just some smartassery that came to mind. :^)
(Score: 2) by mhajicek on Thursday March 01 2018, @03:17PM
That's kinda my point, and I was applying smartassery myself. :)
The spacelike surfaces of time foliations can have a cusp at the surface of discontinuity. - P. Hajicek