Saline vs. Lactated Ringers for Emergency Department IV Fluid Resuscitation

• Status: Completed
• Trial end date: 2017-11-02
• Target enrollment: 0
• Participant gender: All

Summary

Administration of intravascular (IV) fluid is the most common emergency department (ED) procedure. IV fluids are integral to increasing effective blood volume and ensuring organ perfusion in patients with volume depletion and dehydration. There are many options of IV fluids providers can use when treating ED patients. Surveys show physicians do not cite an evidence-based reason for selecting the crystalloid IV fluid used; the decision was likely to be influenced by type and location of practice. A gap exists in the current literature, as there is no evidence for the optimal IV fluid choice for the ED patient requiring IV fluid before discharge.

Normal saline (NS) is commonly used as an IV fluid replacement in ED patients. However, NS has been associated with increased risk of acidosis and acute kidney injury. This study will use a novel approach of a patient-centered outcome in a non-critically ill population to ascertain the optimal IV fluid for patient quality of recovery. The results of this study will inform provider's IV fluid decisions between NS and LR. More importantly, the results of this study will have the power to improve patient's quality of recovery following IV fluid administration and subsequent ED discharge.

ED patients will be recruited, and participants will be randomized to receive one of two IV solutions (Lactated ringer's or normal saline). Participants will answer a survey before and after the intervention to assess their quality of recovery. The post-survey will be administered by phone after ED discharge. Participants will also be contacted by text message one week following their ED visit to gather information on their healthcare utilization.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Nicholas M Mohr; University of Iowa
• Treatments: Pharmaceutical Solutions

Criteria

Inclusion Criteria:

• Emergency department patient

• Chief complaint of nausea, vomiting or emesis, diarrhea, abdominal pain, dehydration, heat stroke or exhaustion

• ED provider approves administration of two liters of fluid

• ED provider states patient is likely to be discharged

• Patient has followed up with PCP in the last two years

• Patient has access to phone for next two days following ED discharge

Exclusion Criteria:

• Prisoners

• Children

• Women known to be pregnant

• Jaundice

• Current chemotherapy