Maintenance fluid therapy in a tertiary hospital: A prevalence study

Area of Science:

• Clinical Pharmacy
• Internal Medicine
• Fluid Therapy Management

Background:

• Maintenance fluid therapy is crucial for hospitalized patients.
• Standard guidelines exist for optimal fluid composition and volume.
• Current hospital practices may deviate from these recommendations.

Purpose of the Study:

• To evaluate the composition and volume of maintenance fluids used in our hospital.
• To compare current fluid therapy practices against established clinical guidelines.
• To identify potential discrepancies in fluid management.

Main Methods:

• Observational, cross-sectional study design.
• Recorded volume and type of fluid therapy over 24 hours.
• Excluded patients with water-electrolyte imbalance.

Main Results:

• Analyzed 124 patients (198 registered, 74 excluded).
• Mean administered volume: 2,500 cc/day.
• Mean daily glucose: 36g; common: normal saline solution (NSS) + 5% glucose (64.4%).
• Excessive sodium (+87.4 mEq) and chloride (+85 mEq) noted.
• Deficits in potassium (-50 mEq), magnesium (-22 mEq), and calcium (-21 mEq) observed.
• Buffer use was infrequent.

Conclusions:

• Normal saline solution is the most frequently prescribed maintenance fluid.
• Current fluid therapy practices show an excess of sodium and chloride.
• Significant deficits in other essential ions, buffering agents, and caloric intake are prevalent.