Medical providers should stop using saline as intravenous fluid therapy for most patients, researchers say, following the release of two new studies that could improve survival and decrease kidney complications.
Saline, used in medicine for more than a century, contains high concentrations of sodium chloride, which is similar to table salt.
Researchers say patients would fare better, if they instead receive balanced fluids that closely resemble the liquid part of blood.
“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,” says study author Matthew Semler, assistant professor of medicine at Vanderbilt University School of Medicine.
“Because balanced fluids and saline are similar in cost, the finding of better patient outcomes with balanced fluids in two large trials has prompted a change in practice at Vanderbilt toward using primarily balanced fluids for intravenous fluid therapy.”
The studies, which appear in the New England Journal of Medicine (study 1, study 2), examined more than 15,000 intensive care patients and more than 13,000 emergency department patients who were assigned to receive saline or balanced fluids if they required intravenous fluid.
In both studies, the incidence of serious kidney problems or death was about 1 percent lower in the balanced fluids group compared to the saline group.
“When we say a 1% reduction, that means thousands and thousands of patients would be better off.”
“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,” says study author Wesley Self, associate professor of emergency medicine.
“When we say a 1 percent reduction, that means thousands and thousands of patients would be better off.”
The authors estimate this change may lead to at least 100,000 fewer patients suffering death or kidney damage each year in the United States.
“Doctors have been giving patients IV fluids for more than 100 years and saline has been the most common fluid patients have been getting,” says study author Todd Rice, associate professor of medicine.
Source: Vanderbilt University