Posted on 02/28/2018 6:34:29 PM PST by BenLurkin
SAN ANTONIO -- Hospitalized patients given IV balanced fluids instead of saline showed a roughly 1% decreased incidence of death and serious kidney injury, according to results of two studies that compared outcomes with the two widely used IV trauma therapies.
The improved outcomes, seen in both critically ill and non-critically ill patients, suggest that largely replacing saline with balanced fluids in the hospital setting could result in significant mortality and morbidity reductions, said Matthew W. Semler, MD, of Vanderbilt University Medical Center in Nashville, in a presentation at the Society of Critical Care Medicine (SCCM) annual meeting. The results were simultaneously published in the New England Journal of Medicine.
...
Buchman said the historical rationale for giving 0.9% saline was that it was compatible with blood transfusions. "But we have reduced the need for blood dramatically in so many (hospital) situations," he said.
The chloride concentration of saline is higher than that of human plasma. Balanced fluids, by contrast, are basically plasma electrolytes with some water. "After roughly 75 years of intravenous medicine and 50 years of advanced trauma life support, we are finally recognizing that maybe what we should be giving is what the patient has been losing," Buchman said.
(Excerpt) Read more at medpagetoday.com ...
Quick guess here - the balanced fluids are patented and have a premium cost, while the saline is a commodity that’s much cheaper for the hospitals.
Thus, the studies funded by the vendors, found the new product to be better.
1%? Seems like that is within the margin of error.
YEP!!
Hook me up with some Gatorade and I'll be fine.
One percent is not statistically significant. They don’t know this?
Quick guess here - the balanced fluids are patented and have a premium cost, while the saline is a commodity that’s much cheaper for the hospitals.
...
Best I can tell is that balanced fluids is the same as lactated Ringer’s and the cost is about the same. It’s been around forever.
If you are going into into surgery, and the surgeon says you have a one percent chance of dying, that’s significant.
The typical “balanced” solution is called lactated Ringers. It is a generic, nonpatented solution. The expense in preparing the solutions (any of them) is the sterility and purity of the ingredients and packaging. The ingredients themselves are not the item.
Here’s an excerpt from another idea to give everybody an idea of why this is significant:
With 4 million hospitalized patients receiving fluids annually nationwide, one in a hundred starts to add up, co-author and ER physician Wesley Self says in a statement.
The study’s authors estimate that more than 50,000 deaths could be avoided with the change and twice as many cases of renal failure. Even just at Vanderbilt, they estimate the switch almost exclusively to balanced fluids could save hundreds of lives a year.
Then do it and let us see the results.
Thanks for the article. 50,000 lives saved is more than die in traffic accidents and thousands more people than die in mass shootings.
Didn’t almost everyone get those with ringers lactate on that show?
Try Brawndo...it’s got electrolytes, it’s what the body craves.
You beat me to it. Ringers Lactate cost more but not much. Any pharmacists or retailers who can comment on this, especially in bulk?
Probably have more Ringers in stock following storm damage to bag mfg in Puerto Rico. No harm in using it. Has another manufacturer of bags been established?
If the sample size is large enough, 1% can actually be a statistically significant result.
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