Vascular Access Conversation - IVUPDATE Podcast from IVTEAM

"In this nationwide observational study, we found that the issuing of different isotonic crystalloid solutions varied based on geographical location" Ellekjaer et al (2022).
IV fluid clinical use study

Abstract:

Background: Intravenous (IV) fluid therapy is a ubiquitous intervention in daily clinical practice. However, nationwide detailed hospital- and departmental-level information on IV fluid use is limited. Hence, we aimed to describe the current issuing of isotonic crystalloid solutions across Danish public hospitals.

Methods: We conducted a nationwide, retrospective observational study describing the issuing of isotonic crystalloid solutions for IV administration, including 0.9% saline, acetate- and lactate-buffered crystalloid solutions. We assessed fluid issuing at national-, regional-, hospital,- and departmental-level from Jan 1, 2021- Dec 31, 2021. We obtained sales figures from the Danish Regional Hospital Pharmacies. Regional characteristics were acquired from the Danish Health Data Authorities online resources. Results are presented graphically and descriptively, including frequencies (%).

Results: The total amount of isotonic crystalloid solutions issued across Danish public hospitals in 2021 was 1,487,144 litres (67.4% saline, 25.9% acetate- and 6.7% lactate-buffered solutions) equivalent to 2.1 litres per hospitalised patient within the study period. Both the issuing of saline vs. buffered crystalloid solutions and the issuing of acetate- vs. lactate buffered solutions varied across geographical regions. Medical departments used saline more frequently (85.3%) than emergency departments (71.5%), surgical departments (70.6%), and anaesthesiological departments including intensive care units (43.0%).

Conclusions: In this nationwide observational study, we found that the issuing of different isotonic crystalloid solutions varied based on geographical location. Furthermore, the issuing of different crystalloid solutions differed across departmental settings with medical departments using the highest proportion of saline and anaesthesiological departments using the highest proportion of buffered crystalloid solutions.

Reference:

Ellekjaer KL, Perner A, Bruun Svan K, Møller MH. Issuing of isotonic crystalloid solutions to Danish public hospitals in 2021 – a retrospective nationwide observational study. Acta Anaesthesiol Scand. 2022 Nov 27. doi: 10.1111/aas.14176. Epub ahead of print. PMID: 36437485.