Is administration of hypotonic intravenous (IV) fluids indicated during sickle cell crisis?

From the Research

Administration of Hypotonic IV Fluids in Sickle Cell Crisis

• The administration of hypotonic intravenous (IV) fluids during sickle cell crisis is not clearly indicated by current research 1, 2, 3, 4.
• Studies have shown that IV hydration is commonly used in emergency and inpatient settings to manage sickle cell disease, but its benefits and optimal usage are not well established 1, 4.
• There is limited evidence to support the use of IV fluids in sickle cell crisis, and potential adverse outcomes such as fluid overload, pulmonary edema, and acute kidney injury have been reported 2, 3, 4.
• Normal saline, a frequently used IV fluid, may be associated with adverse outcomes such as poor pain control and volume overload 4.
• The optimal route, quantity, and type of fluid replacement for people with sickle cell disease during acute painful episodes have not been determined due to a lack of randomized controlled trials 2, 3, 4.
• Intravenous support is considered an essential component in the management of sickle cell-related complications, but the specific use of hypotonic IV fluids is not clearly recommended 5.