A prospective study to assess the usage of intravenous fluids in patients presenting to the emergency department

Authors

  • Sonaxi Agrahari Department of Pharmacy Practice Karnataka College of Pharmacy Rajiv Gandhi University of Health Sciences, Bengaluru, Karnataka, India
  • Abhishek Kumar Sinha Department of Pharmacy Practice Karnataka College of Pharmacy Rajiv Gandhi University of Health Sciences, Bengaluru, Karnataka, India
  • Kreeti Sapkota Department of Pharmacy Practice Karnataka College of Pharmacy Rajiv Gandhi University of Health Sciences, Bengaluru, Karnataka, India
  • Blessy K. Greorge Department of Pharmacy Practice Karnataka College of Pharmacy Rajiv Gandhi University of Health Sciences, Bengaluru, Karnataka, India
  • Balakeshwa Ramaiah Department of Pharmacy Practice Karnataka College of Pharmacy Rajiv Gandhi University of Health Sciences, Bengaluru, Karnataka, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20250488

Keywords:

IV fluids, Emergency department, Fluid therapy, Hydration, Normal saline

Abstract

Background: Intravenous (IV) fluid therapy is a common and critical component in the emergency management of patients. However, inappropriate prescribing and management of IV fluids can result in adverse outcomes.

Methods: This was a prospective observational study involving 132 patients who received IV fluids in the ED. The type of IV fluids, indications, infusion rates and the demographic characteristics of patients were recorded and analyzed.

Results: Out of 132 patients, 80 were female and 52 were male. The most frequently used fluid was Normal Saline (NS) (81%). The primary indication for IV fluid administration was hydration (63.50%). Infusion rates were most commonly bolus infusions (86.13%).

Conclusions: The study revealed that the majority of patients were administered IV fluids for hydration, with NS being the most common fluid. Proper education on fluid management in the ED can improve patient safety and treatment outcomes.

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References

Acheampong A, Vincent JL. A positive fluid balance is an independent prognostic factor in patients with sepsis. Crit Care. 2015;19(1):251. DOI: https://doi.org/10.1186/s13054-015-0970-1

Tinawi M. New trends in the utilization of intravenous fluids. Cureus. 2022;14(5):45. DOI: https://doi.org/10.7759/cureus.14619

Hooper L, Abdelhamid A, Ali A, Bunn D. Diagnostic accuracy of intravenous fluid therapy in the emergency department. J Clin Med. 2022;10(9):1584.

National Institute for Health and Care Excellence (NICE). Intravenous fluid therapy in adults in hospital: CG174. 2017.

Prowle JR, Bellomo R. Fluid administration and the kidney. Curr Opin Crit Care. 2010;16(4):329-36. DOI: https://doi.org/10.1097/MCC.0b013e32833be90b

Yunos NM, Bellomo R, Hegarty C, Story D, Ho L, Bailey M. Association between a chloride-liberal vs chloride-restrictive intravenous fluid administration strategy and kidney injury in critically ill adults. JAMA. 2012;308(15):1566-72. DOI: https://doi.org/10.1001/jama.2012.13356

Caironi P, Tognoni G, Masson S, Fumagalli R, Pesenti A, Romero M, et al. Albumin replacement in patients with severe sepsis or septic shock. N Engl J Med. 2014;370(15):1412-21. DOI: https://doi.org/10.1056/NEJMoa1305727

Myburgh JA, Mythen MG. Resuscitation fluids. N Engl J Med. 2013;369(13):1243-51. DOI: https://doi.org/10.1056/NEJMra1208627

Perner A, Haase N, Guttormsen AB, Tenhunen J, Klemenzson G, Aneman A, et al. Hydroxyethyl starch 130/0.42 versus Ringer’s acetate in severe sepsis. N Engl J Med. 2012;367(2):124-34. DOI: https://doi.org/10.1056/NEJMoa1204242

Semler MW, Self WH, Wanderer JP, Ehrenfeld JM, Wang L, Byrne DW, et al. Balanced crystalloids versus saline in critically ill adults. N Engl J Med. 2018;378(9):829-39.

Finfer S, Myburgh J. Epidemic of intravenous fluid administration. Lancet. 2014;383(9930):2130-2132.

Spiegel R, Parrillo JE. Septic shock and fluid resuscitation—lessons learned. N Engl J Med. 2022;387(15):1363-5.

Gao X, Huang KP, Wu HY, Sun PP, Yan JJ, Chen J, et al. Inappropriate prescribing of intravenous fluid in adult inpatients—a literature review of current practice and research. J Clin Pharm Ther. 2015;40(5):489-95. DOI: https://doi.org/10.1111/jcpt.12295

McClelland H, Vincent JL. Intravenous fluids in septic shock: balancing volume and electrolytes. Lancet Respir Med. 2022;10(4):351-2.

Semler MW, Self WH, Wanderer JP, Ehrenfeld JM, Wang L, Byrne DW, et al. Balanced crystalloids versus saline in critically ill adults. N Engl J Med. 2018;378(9):829-39. DOI: https://doi.org/10.1056/NEJMoa1711584

Young P, Bailey M, Beasley R, Henderson S, Mackle D, McArthur C, et al. SPLIT Trial Investigators. Effect of a buffered crystalloid solution vs saline on acute kidney injury among patients in the ICU: the SPLIT randomized clinical trial. JAMA. 2015;314(16):1701-10. DOI: https://doi.org/10.1001/jama.2015.12334

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Published

2025-02-25

How to Cite

Agrahari, S., Sinha, A. K., Sapkota, K., Greorge, B. K., & Ramaiah, B. (2025). A prospective study to assess the usage of intravenous fluids in patients presenting to the emergency department. International Journal of Basic & Clinical Pharmacology, 14(2), 269–274. https://doi.org/10.18203/2319-2003.ijbcp20250488

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Original Research Articles