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posted by janrinok on Wednesday February 28 2018, @09:04PM   Printer-friendly
from the you're-a-drip dept.

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.

Source: http://www.techtimes.com/articles/222043/20180228/a-new-study-suggests-there-s-a-much-safer-iv-liquid-than-saline.htm


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  • (Score: 5, Interesting) by Spook brat on Wednesday February 28 2018, @10:11PM (7 children)

    by Spook brat (775) on Wednesday February 28 2018, @10:11PM (#645433) Journal

    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 IBM giving 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.

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  • (Score: 1) by khallow on Wednesday February 28 2018, @10:52PM (1 child)

    by khallow (3766) Subscriber Badge on Wednesday February 28 2018, @10:52PM (#645463) Journal
    Weird, I thought I was quoting from the article of the story (went away and came back later) so I didn't bother to link it. Here [medpagetoday.com] is the article I was quoting from.
    • (Score: 2) by Spook brat on Thursday March 01 2018, @12:21PM

      by Spook brat (775) on Thursday March 01 2018, @12:21PM (#645726) Journal

      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.

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  • (Score: 3, Informative) by frojack on Thursday March 01 2018, @01:02AM

    by frojack (1554) on Thursday March 01 2018, @01:02AM (#645536) Journal

    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.

    The case for balanced crystalloids is growing but unproven. A large randomized controlled trial of balanced crystalloids versus 0.9% sodium chloride is the next step.

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  • (Score: 3, Interesting) by Azuma Hazuki on Thursday March 01 2018, @03:15AM (3 children)

    by Azuma Hazuki (5086) on Thursday March 01 2018, @03:15AM (#645588) Journal

    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...

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    • (Score: 1) by khallow on Thursday March 01 2018, @04:12AM

      by khallow (3766) Subscriber Badge on Thursday March 01 2018, @04:12AM (#645600) Journal

      I wonder how they found this out...

      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)

      by Anonymous Coward on Friday March 02 2018, @02:10AM (#646163)

      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

        by Azuma Hazuki (5086) on Friday March 02 2018, @03:08AM (#646178) Journal

        This is the opposite problem: water poisoning, resulting in too little (hypo-) sodium (natr-) in the blood (-aemia).

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