The extent of sodium and water administration associated with i.v. drug infusions in a surgical unit

To quantify sodium and water administered to surgical patients but not actually prescribed by the physician.

Computerized medication records of 1208 surgical patients who were operated on in 1992 were analysed retrospectively. Only prescriptions for intravenous (i.v.) drugs and fluids were selected.

Thirteen of 143 i.v. drugs made up 68.3% of prescriptions for i.v. drugs. Patients received a median of three i.v. drugs daily. Patients were on i.v. therapy for a mean of 4.6 +/- 6.0 days (range 1-140, median 3 days). On 24% of patient-days, patients received more than 100 mEq of sodium which was not consciously prescribed, and on 20.4% of patient-days they had an extra daily intake of 750 ml of water or more. One fourth of the total sodium and more than 15% of fluid administered to patients was in the form of NaCl 0.9%, used as a vehicle for i.v. drugs.

There is a considerable amount of sodium and water administered to patients without a specific prescription. The promotion of knowledge about the correct administration of i.v. drugs is an important task for the clinical pharmacist. If this is achieved, it will allow for an optimal administration of drugs as well as the prevention of possible side effects from an intended sodium and water administration.