THE CMG VOICE

What’s in your IV bag? Should it be?

Recent studies published by the New England Journal of Medicine conclude that “balanced crystalloids” should replace saline as liquid of choice in IV drips for patients.

If you have spent much time in a hospital setting (or watched a hospital-based TV show), you know what an IV drip is: a bag of liquid solution hanging from a pole, with a line down to the patient to deliver the contents of the bag. IVs are used to increase fluids in a patient who may be becoming dehydrated, or to give a patient nutrients or medicine.

Saline – essentially salt dissolved into water – is routinely used in IVs. However, this new research tells us that saline, and particularly the salt in it, is causing a lot of kidney damage. So much, that the researchers estimate switching from saline to balanced crystalloids could save 50,000-70,000 lives and prevent 100,000 cases of kidney failure in the US each year.

The studies involved patients at Vanderbilt, and after the results were known, Vanderbilt itself decided to switch to primarily using balanced crystalloids in their IV bags. Countries in Europe and Australia have already made the switch.

For further reading, an abstract of the results of the studies can be found here:

[Balanced Crystalloids versus Saline in Critically Ill Adults](http://www.nejm.org/doi/full/10.1056/NEJMoa1711584)