From the Guidelines
Intravenous fluids should not be administered every 8 hours, but rather as a continuous infusion to maintain optimal fluid balance and prevent complications. The recommended method of administration is via an infusion pump or gravity drip system, which allows for steady hydration and electrolyte balance 1. For patients requiring IV fluids, common options include balanced crystalloids, such as Ringer's lactate, with rates adjusted based on the patient's condition 1.
Some key points to consider when administering IV fluids include:
- Avoiding the use of 0.9% saline due to the risk of salt and fluid overload 1
- Discontinuing IV fluids postoperatively at the latest during day 1, and encouraging patients to drink and offering an oral diet within 4 hours after abdominal/pelvic surgery 1
- Using hypotonic crystalloids with 70-100 mmol/day of sodium and up to 1 mmol/kg/day of potassium if IV fluids need to be continued postoperatively 1
- Replacing ongoing losses, such as diarrhea or vomiting, with a balanced solution, such as Ringer's lactate, as required 1
Additionally, recent guidelines recommend the use of isotonic fluids, such as lactated Ringer's solution, to reduce the risk of hyponatremia in acutely and critically ill children 1. The guidelines also suggest that the total daily amount of maintenance fluid therapy should be considered, including IV fluids, blood products, and all IV medications, to prevent fluid creep and reduce fluid intake 1.
It is essential to note that the administration of IV fluids should be individualized based on the patient's condition, and the choice of fluid and rate of administration should be guided by the patient's clinical status and laboratory results 1.
From the Research
Administration Frequency
- There is no direct evidence to support the administration of intravenous fluid every 8 hours 2, 3, 4, 5, 6.
- The optimal dose and frequency of intravenous fluid administration vary depending on the patient's condition and clinical scenario 2.
Method of Administration
- Rapid fluid administration can be achieved through various methods, including larger vein size, larger bore cannula, height of fluid, and pressure over the fluid bottle 3.
- A novel method for rapid infusion has been described, which can be utilized in emergency and trauma settings 3.
- Continuous infusion of fluids can be an effective and safe method of administration, particularly in cases of fluid overload refractory to conventional therapy 5.
- The choice of fluid type, such as normal saline or lactated Ringer's solution, may not significantly impact the quality of recovery in stable patients 6.
Key Considerations
- Both inadequate and excessive intravenous fluid administration can lead to poor outcomes, including increased risk of infection and organ dysfunction 2.
- The selection of the optimal dose and method of administration should be individualized based on the patient's specific needs and clinical scenario 2, 4, 5.