Assessing Toxicity of Intravenous Crystalloids in Critically Ill Patients

Certain drugs can vary widely in effectiveness and toxicity when given intravenously instead of enterally and vice versa. Even water can be harmful when given intravenously. It is important to study the effects of IV administered drugs because they can be dramatic and unique within the side effect profile of the drug. Moreover, the malignancy of the adverse effects follows a vicious cycle, where more of the drug is being administered to an unhealthy patient than to a healthier patient who can also usually minimize the side effects of the drug.

Albumin and hydroxyl starch solutions were shown to increase the chance of death in patients when given IV. Treatment with these drugs should be closely monitored and alternative methods of treatment should be considered. One of the most commonly administered IV fluids is isotonic 0.9% saline solution, and its effects have been well studied for decades. This study compared the effects of this saline solution and a buffered electrolyte solution.

The study focused on the appearance of acute kidney injury (AKI), since that is a commonly occurring adverse effect for these drugs. The study showed that there is no appreciable difference between the two drugs in this respect. The value of this study is that it shows that neither of these therapies are harmful or risky treatment options.

Kellum JA, Shaw AD. Assessing Toxicity of Crystalloids in Critically Ill Patients. The Journal of the American Medical Association. 2015: 314(16): 1695-1697.

 

1 thought on “Assessing Toxicity of Intravenous Crystalloids in Critically Ill Patients”

  1. I’m confused, I thought you said that, “Albumin and hydroxyl starch solutions were shown to increase the chance of death in patients when given IV.” However the result of the study was that the two drugs/ drug therapies are not harmful or risky. Is this just because monitoring is effective in reducing risk? When you said these two drugs were you talking about saline and electrolyte solution instead?

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