So Long, Saline?

Study shows link between saline IVs and severe kidney dysfunction


There’s a lot that medical dramas like ER or Grey’s Anatomy get wrong about hospitals, but one thing they get right is that IVs are pretty ubiquitous hospital equipment. Almost all of the 30 million patients admitted to hospitals in the United States each year are hooked up to an IV, which likely contains saline, a high-concentrate sodium chloride solution. A study published in the New England Journal of Medicine, however, suggests that hospitals might want to think twice about filling their IV bags with saline.

Researchers at Vanderbilt University School of Medicine used Epic to monitor the outcomes of more than 15,000 intensive care patients and more than 13,000 emergency department patients who had an IV inserted during their hospital stay. About 50% of these patients’ IVs contained a standard saline solution, while the other 50% contained a balanced crystalloid solution, which more closely resembles blood plasma. The incidence of serious kidney problems or death was about 1% lower in the balanced-fluids group compared to the saline group.

“The difference, while small for individual patients, is significant on a population level. Each year in the United States, millions of patients receive intravenous fluids,” said study author Dr. Wesley Self, associate professor of Emergency Medicine. “When we say a 1% reduction, that means thousands and thousands of patients would be better off.” Because many IV bag suppliers manufacture both saline and balanced-solution bags at a similar cost, Vanderbilt has begun making the switch to balanced-solution IVs.

Read more here.