Ideal time to replace isotonic crystalloid intravenous fluids and sets

Area of Science:

• Veterinary Medicine
• Infectious Disease Prevention
• Fluid Therapy Management

Background:

• Intravenous (IV) fluid contamination poses a risk for bloodstream infections in veterinary patients.
• Current guidelines for IV fluid and set replacement intervals vary, necessitating evidence-based recommendations.
• Previous research by Fausak et al. (2016) explored optimal IV fluid replacement times.

Purpose of the Study:

• To update knowledge on the ideal duration for hanging isotonic crystalloid intravenous fluids and sets in dogs and cats.
• To determine if changing IV fluids every 96 hours, compared to longer durations, reduces the risk of fluid bag contamination.

Main Methods:

• Review of two prospective veterinary studies and one human Cochrane systematic review.
• Analysis of studies examining contamination incidence in IV fluid bags under various conditions.
• Evaluation of factors influencing fluid contamination, including environmental cleanliness and port disinfection.

Main Results:

• Consistency observed between a human systematic review and a veterinary intensive care unit (ICU) experimental design.
• One veterinary experimental study showed no contamination over 60 days but had limitations in external validity due to a controlled laboratory setting and port disinfection.
• Veterinary studies were limited to non-additive IV fluid bags not connected to live animals or IV sets.

Conclusions:

• Based on available evidence, IV fluid bags and sets should be changed every 72-96 hours.
• Environmental cleanliness and routine alcohol wiping of ports before injections or withdrawals may significantly decrease fluid contamination.
• Further experimental studies with low risk of bias in clinical veterinary patients are needed to strengthen evidence.