Probably every hospital room in the developed world is fitted with a hospital bed and an IV bag. That hospital beds can serve as a breeding ground for infection is a well-established fact, but it turns out that the IV bags administered to nearly every hospital patient also pose a huge threat to your kidney health.
Intravenous saline solution, which is little more than salt dissolved in water, has been widely used in hospitals to prevent dehydration, provide critical nutrients and maintain blood pressure for more than a century. According to two recent studies, it might be time to revisit this practice. As reported by MedPage Today, up to 70,000 deaths annually could be avoided by replacing saline with balanced fluids.
The standard saline solution is 0.9 percent sodium chloride and gained widespread acceptance because it was compatible with blood transfusions, which were a common practice in past decades. But medical practices have changed greatly in the last century and the fact that the classic IV solution has a higher concentration of saline than human plasma can inflict serious damage on the kidneys.
Both studies concluded that balanced fluids used in place of saline, which is far more prevalent in U.S. hospitals, could significantly reduce hospital deaths and serious kidney damage. Lactated Ringer and Plasma Lyte© are two of the most common balanced fluids. These formulations also contain saline but more closely resemble plasma, the clear component of blood which is more than 90 percent water. Balanced fluids also contain potassium, magnesium and other electrolytes. Overall, patients given balanced fluids showed a 1 percent decrease in death and serious kidney damage.
It was found that the choice of IV fluids was often linked to the doctor’s background. Surgeons and anesthesiologists used balanced fluids while internal medicine doctors mostly relied on the older saline formula. The use of balanced fluids was associated with a much lower incidence of major adverse kidney events. Up to 100,000 cases of renal failure could be avoided by making the switch. Balanced fluids cost about the same as saline solution.
One of the studies involved 28,000 patients at Vanderbilt University and the results convinced the institution to switch to balanced fluids. Patients were given either saline or balanced fluids and the 1 percent drop in death and adverse events was more than enough to prompt the change.
The second study also spotlighted the dangers posed by IV saline solution. This study focused on children with septic shock and how hypochloremia, an electrolyte imbalance caused by elevated chloride levels, leads to increased mortality rates and poorer outcomes.
Dr. Erin Stetson, of Cincinnati’s Children’s hospital, argued that, “Since the use of normal saline is the most prevalent fluid that has been given at our institution, we presume that this [hyperchloremia] was due to the use of normal saline.”
Emory University’s critical specialist Dr. Timothy Buchman, told MedPage Today that these studies should lead to major changes. “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.”
This is more evidence that you should make a point of avoiding hospitals unless absolutely necessary. Approximately 40,000 harmful or lethal hospital errors occur each and every day in the U.S. Balanced fluids have been more prevalent in Europe and Australia for some time, and these studies suggest that it might be wise for U.S. medical establishment to start looking for safer alternatives as well.
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