Intravenous Fluids

Intravenous (IV) fluid therapy is a ubiquitous treatment for critically ill patients and has been used in clinical practice for over 175 years. Despite this long history, IV fluids have not been subjected to the same level of scrutiny as pharmaceutical drugs. Physicians have long debated the choice of IV fluid in critically ill patients, with ongoing controversy over the relative effectiveness and safety of various solutions.

Over the past decade, the MRINZ has run a landmark programme of research dedicated to determining the optimal IV fluid treatments in critically ill patients. The main focus has been determining whether using balanced crystalloid fluids, which includes a combination of water and electrolytes and thus more closely mimics human plasma, results in better patient outcomes than when saline is used.

As part of an international research effort, MRINZ-led randomised controlled trials have now been combined in a meta-analysis of all studies in this field. Ths analysis shows that balanced crystalloid fluids reduce the risk of death compared to saline for all critically ill patients except those with traumatic brain injuries.

The uncertainty around IV fluid choice is now resolved, changing the practice of one of the most fundamental therapies administered to acutely unwell patients. The global impact with the implementation of these findings in clinical practice is likely to be immense.

DIRECTOR

Intensive Care Medicine Programme Lead Oxygen Therapy Programme co-Lead

Associate Professor Matire Harwood

DEPUTY DIRECTOR