To assess whether focused decreases in intraoperative fluid use could safely enhance patient care during a nationwide IV fluid supply crisis.
Approach:
Study Design: Retrospective cohort study involving patients receiving anesthesia care at a quaternary hospital network in the Bronx, New York, from September 2 to December 31, 2024.
Intervention: Introduction of a structured fluid-reduction bundle aimed at optimizing intraoperative crystalloid administration.
Data Collection: Data obtained from electronic health records, including costs of intravenous fluids and patient outcomes.
Outcomes: Primary measure was intraoperative crystalloid volume; secondary measures included urine output, Foley catheter use, postoperative complications, and hospital costs.
Key Findings:
Liberal fluid administration during surgery has been associated with postoperative complications, including respiratory failure and delayed recovery.
The fluid reduction bundle intervention included 12 measures specifically intended to decrease crystalloid infusion volume.
Cost analyses were conducted to evaluate the financial impact of the intervention.
Interpretation:
The study suggests that implementing a structured fluid-reduction strategy can lead to a significant decrease in intraoperative crystalloid volume without compromising patient safety. By optimizing fluid management, it is possible to reduce the incidence of postoperative complications and enhance recovery times, which is particularly crucial during a nationwide IV fluid supply crisis.
Limitations:
The study is retrospective and may be subject to biases inherent in such designs.
Data were collected from a single hospital network, which may limit generalizability.
Conclusion:
The findings from this study will provide valuable insights into the effectiveness of fluid management strategies during a supply crisis, highlighting the potential for improved patient outcomes and cost savings. This research underscores the importance of adapting clinical practices in response to resource limitations while maintaining high standards of patient care.
by Noah Hopstein, Felix Borngaesser, Lorenz Droege, Rafi Khandaker, Michael E. Kiyatkin, Michael L. Rinke, Peter P. Semczuk, Jeffrey M. Weiss, Nicholas Kolmel, Mark Condoleo, Karuna Wongtangman, Ali Bordbar Jahantighi, Ibraheem M. Karaye, Tomer Kotek, Adela M. Aguirre-Alarcon, Constance Rippel, Dorothee S. Straetz, Michele C. Siciliano, Jason Hallick, Aiman M. Suleiman, Andrew D. Racine, Matthias Eikermann
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