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Journal articles on the topic 'Intravenous fluid'

Author: Grafiati
Published: 4 June 2021
Last updated: 4 February 2022

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1

Kumar, Gautam, Ellie Walker, and Robert Stephens. "Intravenous fluid therapy." Trends in Anaesthesia and Critical Care 4, no. 2-3 (June 2014): 55–59. http://dx.doi.org/10.1016/j.tacc.2014.04.005.

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2

Lassen, K. "Intravenous fluid therapy." British Journal of Surgery 96, no. 2 (February 2009): 123–24. http://dx.doi.org/10.1002/bjs.6466.

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3

Hoorn, Ewout J. "Intravenous fluids: balancing solutions." Journal of Nephrology 30, no. 4 (November 29, 2016): 485–92. http://dx.doi.org/10.1007/s40620-016-0363-9.

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Abstract The topic of intravenous (IV) fluids may be regarded as “reverse nephrology”, because nephrologists usually treat to remove fluids rather than to infuse them. However, because nephrology is deeply rooted in fluid, electrolyte, and acid-base balance, IV fluids belong in the realm of our specialty. The field of IV fluid therapy is in motion due to the increasing use of balanced crystalloids, partly fueled by the advent of new solutions. This review aims to capture these recent developments by critically evaluating the current evidence base. It will review both indications and complications of IV fluid therapy, including the characteristics of the currently available solutions. It will also cover the use of IV fluids in specific settings such as kidney transplantation and pediatrics. Finally, this review will address the pathogenesis of saline-induced hyperchloremic acidosis, its potential effect on outcomes, and the question if this should lead to a definitive switch to balanced solutions.
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4

Barlow, Ashley, Brooke Barlow, Nancy Tang, Bhavik M. Shah, and Amber E. King. "Intravenous Fluid Management in Critically Ill Adults: A Review." Critical Care Nurse 40, no. 6 (December 1, 2020): e17-e27. http://dx.doi.org/10.4037/ccn2020337.

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Topic This article reviews the management of intravenous fluids and the evaluation of volume status in critically ill adults. Clinical Relevance Intravenous fluid administration is one of the most common interventions in the intensive care unit. Critically ill patients have dynamic fluid requirements, making the management of fluid therapy challenging. New literature suggests that balanced salt solutions may be preferred in some patient populations. Purpose of Paper The bedside critical care nurse must understand the properties of various intravenous fluids and their corresponding impact on human physiology. The nurse’s clinical and laboratory assessments of each patient help define the goals of fluid therapy, which will in turn be used to determine the optimal patient-specific selection and dose of fluid for administration. Nurses serve a vital role in monitoring the safety and efficacy of intravenous fluid therapy. Although this intervention can be lifesaving, inappropriate use of fluids has the potential to yield detrimental effects. Content Covered This article discusses fluid physiology and the goals of intravenous fluid therapy, compares the types of intravenous fluids (isotonic crystalloids, including 0.9% sodium chloride and balanced salt solutions; hypotonic and hypertonic crystalloids; and colloids) and their adverse effects and impact on hemodynamics, and describes the critical care nurse’s essential role in selecting and monitoring intravenous fluid therapy.
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Siddiqui, Aamir. "Intravenous Fluid Resuscitation: Breaking the Dilemma." Nepalese Medical Journal 1, no. 2 (December 2, 2018): 104–11. http://dx.doi.org/10.3126/nmj.v1i2.21625.

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Intravenous fluids are a core element in the resuscitation of critically ill patients, and choice & manage­ment strategies vary widely in day-to-day medical practice. With the advancement in the understanding and implementation of aggressive fluid resuscitation, has also come a greater awareness of the resultant fluid toxicity. As such, the discussion regarding intravenous solutions continues to evolve especially as it pertains to their effect on kidney and metabolic function, electrolytes, and ultimately patient outcome. This review discusses the fluid management from the perspective of resuscitative strategies, and is expected to guide clinical practitioners in fluid decision-making for common clinical scenarios encountered at acute care setups.
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Anthony, John, and Leann K. Schoeman. "Fluid management in pre-eclampsia." Obstetric Medicine 6, no. 3 (July 26, 2013): 100–104. http://dx.doi.org/10.1177/1753495x13486896.

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Intravenous fluid given to women with pre-eclampsia may be a necessary form of treatment; however, intravenous fluid therapy can also cause iatrogenic pulmonary oedema. The indications for the use of intravenous fluids, the titration of the amount of fluid given and the use of invasive monitoring have not been subject to adequate examination in randomised studies. Clinical experience, combined with available evidence and a reasoned approach are the basis for a suggested management algorithm.
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Alvarado Sánchez, Jorge Iván, William Fernando Amaya Zúñiga, and Manuel Ignacio Monge García. "Predictors to Intravenous Fluid Responsiveness." Journal of Intensive Care Medicine 33, no. 4 (May 16, 2017): 227–40. http://dx.doi.org/10.1177/0885066617709434.

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Management with intravenous fluids can improve cardiac output in some surgical patients. Management with static preload indicators, such as central venous pressure and pulmonary artery occlusion pressure, has not demonstrated a suitable relationship with changes in the cardiac output induced by intravenous fluid therapy. Dynamic indicators, such as the variability of arterial pulse pressure or stroke volume variation, have demonstrated a suitable relationship. Since improvement in cardiac output does not guarantee an adequate perfusion pressure, in patients with hypotension, it is also necessary to know whether arterial pressure will also increase with intravenous fluid therapy. In this regard, the functional assessment of arterial load by dynamic arterial elastance could help to determine which patients will improve not only their cardiac output but also their mean arterial pressure.
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8

Mathur, Abhinav, Gwen Johnston, and Laura Clark. "Improving intravenous fluid prescribing." Journal of the Royal College of Physicians of Edinburgh 50, no. 2 (June 2020): 181–87. http://dx.doi.org/10.4997/jrcpe.2020.224.

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9

LEWIS, F. R. "Prehospital Intravenous Fluid Therapy." Survey of Anesthesiology XXXI, no. 4 (August 1987): 218. http://dx.doi.org/10.1097/00132586-198708000-00026.

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10

Rushton, A. M. "Therapeutics. Intravenous Fluid Therapy." British Journal of Anaesthesia 93, no. 5 (November 2004): 751. http://dx.doi.org/10.1093/bja/aeh628.

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11

Grint, Nicki. "Intravenous fluid therapy calculations." Veterinary Nursing Journal 23, no. 2 (February 2008): 12–16. http://dx.doi.org/10.1080/17415349.2008.11013653.

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12

Chaudhari, S., and S. Feaver. "Falling intravenous fluid container." Anaesthesia 62, no. 8 (August 2007): 861–62. http://dx.doi.org/10.1111/j.1365-2044.2007.05213.x.

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13

Bai, Sun Joon, Jong Wha Lee, and Ki-Young Lee. "Fluid therapy: classification and characteristics of intravenous fluids." Journal of the Korean Medical Association 53, no. 12 (2010): 1103. http://dx.doi.org/10.5124/jkma.2010.53.12.1103.

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Ding, Xiaoqiang, Zhen Cheng, and Qi Qian. "Intravenous Fluids and Acute Kidney Injury." Blood Purification 43, no. 1-3 (2017): 163–72. http://dx.doi.org/10.1159/000452702.

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Over 50% of the human body is comprised of fluids that are distributed in defined compartments. Although compartmentalized, these fluids are dynamically connected. Fluids, electrolytes, and acid-base balance in each compartment are tightly regulated, mostly in an energy-dependent manner to achieve their designed functions. For over a century, our understanding of the microvascular fluid homeostasis has evolved from hypothesized Ernest Starling principle to evidence-based and the revised Starling principle, incorporating the functional endothelial surface layer. The kidney is a highly vascular and encapsulated organ that is exquisitely sensitive to inadequate (insufficient or excess) blood flow. The kidney is particularly sensitive to venous congestion, and studies show that reduced venous return triggers a greater degree of kidney damage than that from lacking arterial flow. Thus, fluid overload can induce severe and sustained kidney injury. In the setting of established acute kidney injury, fluid management can be challenging. Impaired capacity of urine output and urine concentration and dilution should be taken into consideration when designing fluid therapy. Video Journal Club ‘Cappuccino with Claudio Ronco' at http://www.karger.com/?doi=452702.
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15

Kurniatie, Menik Dwi. "ANALISIS FAKTOR KEJADIAN PHLEBITIS DENGAN SIMULASI MODEL FISIS ALAT TERAPI INTRAVENA." Jurnal SainHealth 3, no. 1 (March 23, 2019): 21. http://dx.doi.org/10.51804/jsh.v3i1.336.21-29.

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Intravenous therapy through long-term infusion is at risk for complications such as phlebitis. The influence of medical factors with a history of hypertension and mechanical factors based on the location of the position of infusion is the main study of the causes of phlebitis.One of the causes of phlebitis is the flow of intravenous fluids which is not proportional to the volume of infusion fluid. Intravenous Therapy Devices with the aim of assessing the physical phenomena modeling experiments intravenous therapy with the theory of fluid mechanics and prove the existence of linkage patient's blood pressure and height of intravenous fluid drop rate. The research method is experimental with the physical modeling of intravenous therapeutic devices. Physical model of intravenous therapy devices using a manometer to measure the pressure tube as diastolic pressure and variation on fluid infusion used was NaCl 0.9% and Glucose 5%. The results of this research was obtained diastolic pressure below 80 mmHg produced a drop rate of fluid infusion is almost constant with a maximum height of a standard intravena pole 1meter, while at an altitude above the altitude variation of normal use by 90 mmHg diastolic pressure with height variations of 1.1 to 1.3 meters yield drop rate a linear of infusion liquid to height variations. So to prevent turbulence of intravenous fluids (the cause of phlebitis) by increasing the location standard for infusion
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Vivekanantham, Sayinthen, Giada Azzopardi, and Rahul Prashanth Ravindran. "‘Fluid-wise routefoolish’: intravenous vs enteral fluid administration." British Journal of Hospital Medicine 75, no. 4 (April 2, 2014): 236. http://dx.doi.org/10.12968/hmed.2014.75.4.236.

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17

Berchtold, Joachim. "Intravenous Fluid Therapy of Calves." Veterinary Clinics of North America: Food Animal Practice 15, no. 3 (November 1999): 505–31. http://dx.doi.org/10.1016/s0749-0720(15)30161-4.

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18

Hallowell, Gayle D., and Timothy J. Potter. "Intravenous fluid therapy in cattle." Livestock 14, no. 1 (January 2009): 30–34. http://dx.doi.org/10.1111/j.2044-3870.2009.tb00209.x.

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19

Givan, Gordon V., and Jason J. Diehl. "Intravenous Fluid Use in Athletes." Sports Health: A Multidisciplinary Approach 4, no. 4 (June 19, 2012): 333–39. http://dx.doi.org/10.1177/1941738112446285.

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20

Tremblay, Robert R. M. "Intravenous Fluid Therapy in Calves." Veterinary Clinics of North America: Food Animal Practice 6, no. 1 (March 1990): 77–101. http://dx.doi.org/10.1016/s0749-0720(15)30896-3.

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21

Sheehy, T. W. "ORIGINS OF INTRAVENOUS FLUID THERAPY." Lancet 333, no. 8646 (May 1989): 1081. http://dx.doi.org/10.1016/s0140-6736(89)92479-3.

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22

Clifford, Theresa. "Spiking of Intravenous Fluid Solutions." Journal of PeriAnesthesia Nursing 26, no. 6 (December 2011): 424–25. http://dx.doi.org/10.1016/j.jopan.2011.09.001.

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23

Dhamrait, Rajvinder Singh. "Fasciotomy following intravenous fluid infiltration." Pediatric Anesthesia 16, no. 10 (October 2006): 1097. http://dx.doi.org/10.1111/j.1460-9592.2006.01960.x.

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24

Majid, S. H., M. Yusro, P. Yuliatmojo, and K. N. Siregar. "Web-based intravenous fluid monitoring." IOP Conference Series: Materials Science and Engineering 1098, no. 4 (March 1, 2021): 042085. http://dx.doi.org/10.1088/1757-899x/1098/4/042085.

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25

Boomer, Laura, Wright Jones, Brett Davis, Shelley Williams, and Annabel Barber. "Optimal Fluid Resuscitation: Timing and Composition of Intravenous Fluids." Surgical Infections 10, no. 5 (October 2009): 379–87. http://dx.doi.org/10.1089/sur.2008.097.

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26

Sony, Jithin, Ann Sunny, and Anthony Prakash Rozaria. "Intravenous fluids in acute pancreatitis: a prospective study." International Surgery Journal 7, no. 10 (September 23, 2020): 3365. http://dx.doi.org/10.18203/2349-2902.isj20204138.

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Background: Fluid therapy is the mainstay of treatment in the management of acute pancreatitis. Most guidelines recommend aggressive fluid therapy in the initial 48-72 hours. We aimed to compare the occurrence, persistence or worsening of systemic inflammatory response syndrome (SIRS) and occurrence organ failure in patients with acute pancreatitis receiving normal and high volume fluid therapy in the first 24 hours.Methods: This was a prospective observational study. Consecutive adult patients admitted with acute pancreatitis were included in the study. SIRS was defined according to the criteria. Organ failure and local complications were defined according to Atlanta classification. Patients were divided into two groups according to the rate of fluid administered in the initial 24 hours: Normal volume group which received fluids at a rate <150 ml/hour and high volume group >150 ml/hour.Results: A total 60 patients were included in the study with 30 each in the two groups. Persistence or worsening of SIRS at 48 hours was more in normal volume fluid group compared to the high volume fluid group (p=0.076). Organ failure at 48 hours was more in normal volume fluid group compared to the high volume fluid group (p=0.074). Incidence of local complications equal in both group.Conclusions: Our study did not show any statistically significant difference in outcomes in patients with acute pancreatitis receiving normal or high volume fluids in the initial 24 hours. Further multi-centric randomised control trials are required to analyze the outcomes of high and normal volume fluid resuscitation in acute pancreatitis.
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Asrani, Varsha M., Annabelle Brown, Ian Bissett, and John A. Windsor. "Impact of Intravenous Fluids and Enteral Nutrition on the Severity of Gastrointestinal Dysfunction: A Systematic Review and Meta-analysis." Journal of Critical Care Medicine 6, no. 1 (January 31, 2020): 5–24. http://dx.doi.org/10.2478/jccm-2020-0009.

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AbstractIntroductionGastrointestinal dysfunction (GDF) is one of the primary causes of morbidity and mortality in critically ill patients. Intensive care interventions, such as intravenous fluids and enteral feeding, can exacerbate GDF. There exists a paucity of high-quality literature on the interaction between these two modalities (intravenous fluids and enteral feeding) as a combined therapy on its impact on GDF.AimTo review the impact of intravenous fluids and enteral nutrition individually on determinants of gut function and implications in clinical practice.MethodsRandomized controlled trials on intravenous fluids and enteral feeding on GDF were identified by a comprehensive database search of MEDLINE and EMBASE. Extraction of data was conducted for study characteristics, provision of fluids or feeding in both groups and quality of studies was assessed using the Cochrane criteria. A random-effects model was applied to estimate the impact of these interventions across the spectrum of GDF severity.ResultsRestricted/ goal-directed intravenous fluid therapy is likely to reduce ‘mild’ GDF such as vomiting (p = 0.03) compared to a standard/ liberal intravenous fluid regime. Enterally fed patients experienced increased episodes of vomiting (p = <0.01) but were less likely to develop an anastomotic leak (p = 0.03) and peritonitis (p = 0.03) compared to parenterally fed patients. Vomiting (p = <0.01) and anastomotic leak (p = 0.04) were significantly lower in the early enteral feeding group.ConclusionsThere is less emphasis on the combined approach of intravenous fluid resuscitation and enteral feeding in critically ill patients. Conservative fluid resuscitation and aggressive enteral feeding are presumably key factors contributing to severe life-threatening GDF. Future trials should evaluate the impact of cross-interaction between conservative and aggressive modes of these two interventions on the severity of GDF.
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Kinlin, Laura M., Andrew J. Helmers, Jeremy N. Friedman, and Carolyn E. Beck. "Choice of maintenance intravenous fluids among paediatric residents in Canada." Paediatrics & Child Health 25, no. 8 (September 19, 2019): 518–24. http://dx.doi.org/10.1093/pch/pxz093.

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Abstract Background Recent literature and guidelines support routine use of isotonic intravenous (IV) fluids for maintenance therapy in hospitalized infants and children. Current prescribing practices are unknown. Objective To elicit paediatric residents’ choice of maintenance IV fluids, particularly with regard to tonicity, in a variety of clinical scenarios and patient ages. We hypothesized that residents would choose isotonic fluids in most cases, but there would be substantially more variability in fluid choice in the neonatal age group. Methods An Internet-based survey was e-mailed to trainees in the 17 paediatric residency programs across Canada, via the Canadian Paediatric Program Directors. The survey instrument included questions related to training, followed by a series of questions eliciting choice of IV fluid in a variety of clinical situations. Results A total of 147 survey responses were submitted (22% response rate). Isotonic solutions were selected by &gt;75% across all clinical scenarios involving infants and children. Very hypotonic fluids were seldom chosen. There was more variability in fluid choice in neonates, with evidence of significant differences in fluid tonicity based on senior versus junior resident status and geographical location. Conclusions Results imply a predominance of isotonic fluid use in infants and children, suggesting that clinical practice has changed in response to risk of hyponatremia with hypotonic IV fluids. As hypothesized, there was more variability with respect to choice of maintenance fluids in neonates. This likely reflects a paucity of guidance in an age group with unique physiologic factors affecting fluid and electrolyte status.
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Kowalczyk, J. J., M. Yurashevich, N. Austin, and B. Carvalho. "In vitro intravenous fluid co-load rates with and without an intravenous fluid warming device." International Journal of Obstetric Anesthesia 38 (May 2019): 149–50. http://dx.doi.org/10.1016/j.ijoa.2018.12.003.

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30

Brien, Lori Dugan, Marilyn H. Oermann, Margory Molloy, and Catherine Tierney. "Implementing a Goal-Directed Therapy Protocol for Fluid Resuscitation in the Cardiovascular Intensive Care Unit." AACN Advanced Critical Care 31, no. 4 (December 15, 2020): 364–70. http://dx.doi.org/10.4037/aacnacc2020582.

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Background Balancing fluid administration and titration of vasoactive medications is critical to preventing postoperative complications in cardiac surgical patients. Objective To evaluate the impact of implementing a goal-directed therapy protocol in the cardiovascular intensive care unit on total intravenous fluids administered on the day of surgery, rates of acute kidney injury, and hospital length of stay. Methods A fluid resuscitation protocol using dynamic assessment of fluid responsiveness with stroke volume index was developed, and nurses were prepared for its implementation using simulation training. Results After implementation of the new protocol, the total amount of intravenous fluids administered on the day of surgery was significantly reduced (P = .003). There were no significant changes in hospital length of stay (P = .83) or rates of acute kidney injury (P = .86). There were significant increases in nurses’ knowledge of (P &lt; .001) and confidence in (P &lt; .001) fluid resuscitation and titration of vasoactive medications after simulation training. Conclusions Use of a fluid resuscitation protocol resulted in a reduction in the amount of intravenous fluids administered on the day of surgery. The simulation training increased nurses’ knowledge of and confidence in fluid resuscitation and titration of vasoactive medications.
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Aber, Tracy S., Anita Marie Hosac, Marianne Penrose Veach, and Yvette Whitney Pierre. "Fluid Therapy in the Critically Ill Patient." Journal of Pharmacy Practice 15, no. 2 (April 2002): 114–23. http://dx.doi.org/10.1106/5qg8-t9bj-46ly.

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The administration of intravenous fluids in the critically ill patient presents many challenges for clinicians. Intravenous fluids are usually categorized as either crystalloids or colloids, with each having distinct advantages and disadvantages in various patient populations. The appropriate selection of fluid type remains an issue of great debate in the critical care literature and has been the subject of numerous comparative studies. Despite the vast amount of data available, there is no clear consensus in the literature to direct the clinician in the choice of fluid type. This article will provide an overview of fluid distribution within the body and the factors that affect this distribution, a review of the various types of fluids administered in the critically ill patient, and the rationale for the selection of each type. A review of the literature surrounding the colloid-crystalloid controversy is provided.
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32

Sutin, Kenneth M., Keith J. Ruskin, and Brian S. Kaufman. "Intravenous Fluid Therapy in Neurologic Injury." Critical Care Clinics 8, no. 2 (April 1992): 367–408. http://dx.doi.org/10.1016/s0749-0704(18)30256-2.

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33

Turner, Neil. "The invention of intravenous fluid therapy." Journal of Renal Nursing 5, no. 6 (November 2013): 314. http://dx.doi.org/10.12968/jorn.2013.5.6.314.

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Cosnett, J. E. "THE ORIGINS OF INTRAVENOUS FLUID THERAPY." Lancet 333, no. 8641 (April 1989): 768–71. http://dx.doi.org/10.1016/s0140-6736(89)92583-x.

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35

Reddick, A. D., J. Ronald, and W. G. Morrison. "Intravenous fluid resuscitation: was Poiseuille right?" Emergency Medicine Journal 28, no. 3 (June 26, 2010): 201–2. http://dx.doi.org/10.1136/emj.2009.083485.

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36

Segar, Jeffery L. "AAP recommends isotonic maintenance intravenous fluid." Journal of Pediatrics 208 (May 2019): 294–97. http://dx.doi.org/10.1016/j.jpeds.2019.02.049.

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Reddy, Pramod. "Intravenous Fluid Therapy in Hospitalized Patients." American Journal of Therapeutics 26, no. 4 (2019): e489-e494. http://dx.doi.org/10.1097/mjt.0000000000000704.

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BICKELL, WILLIAM H. "Intravenous Fluid Administration and Uncontrolled Hemorrhage." Journal of Trauma: Injury, Infection, and Critical Care 29, no. 3 (March 1989): 409. http://dx.doi.org/10.1097/00005373-198903000-00028.

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Frost, P. "Intravenous fluid therapy in adult inpatients." BMJ 350, jan06 13 (January 6, 2015): g7620. http://dx.doi.org/10.1136/bmj.g7620.

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Wüger, C., R. Straub, and V. Gerber. "Intravenous fluid therapy in the horse." Pferdeheilkunde Equine Medicine 22, no. 3 (2006): 327–33. http://dx.doi.org/10.21836/pem20060313.

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McKane, Shaun A. "Intravenous fluid therapy in the horse." Veterinary Nursing Journal 28, no. 3 (March 2013): 78–80. http://dx.doi.org/10.1111/vnj.12020.

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McNab, Sarah. "Intravenous maintenance fluid therapy in children." Journal of Paediatrics and Child Health 52, no. 2 (February 2016): 137–40. http://dx.doi.org/10.1111/jpc.13076.

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Gray, Jenny, and Susie Gage. "P13 Optimising paediatric intravenous fluid management plans: a quality improvement project." Archives of Disease in Childhood 105, no. 9 (August 19, 2020): e12.2-e13. http://dx.doi.org/10.1136/archdischild-2020-nppg.22.

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IntroductionIntravenous (IV) maintenance fluids are often prescribed post-surgery when enteral routes are contraindicated. Serious consequences have been documented when poor fluid management has occurred, as highlighted in the National Patient Safety Alert (NPSA) 22; reducing the risk of hyponatraemia; when administering IV fluids to children.1 In response to this, the National Institute for Health and Care Excellence (NICE) published their guidance in December 2015 regarding IV fluids in children.2 Based on NICE recommendations, a pan hospital fluid guidance was produced. Within the NICE and hospital’s own guideline it states that there should be a daily fluid management plan documented. It has been well recognised that this daily fluid management plan was not routinely been completed; hence showing non-adherence to our hospital policy and NICE recommendations.AimsPrimary aim was to improve the documentation of the daily fluid management plan; aimed at the medical staff and the secondary aim was to improve the monitoring requirements of IV fluids and documentation of these; largely aimed at the nursing staff.MethodsA simple sticker was designed and attached to continuous sheets for medical notes which had a checklist of monitoring requirements and a section for fluid balance. Additionally, 2 posters were produced; one aimed at medical staff for documenting a fluid management plan and one aimed at the nursing staff with the monitoring requirements. These posters were displayed on the paediatric surgical ward.ResultsA total of 22 patients who were prescribed IV fluids were identified for a baseline measurement, an equal number of patients were compared after the intervention. Neonates and children receiving total parenteral nutrition were excluded from the data collection. There were 41% of daily fluid management plans completed pre intervention and post intervention there were 56% completed; showing a 15% increase in completion. As regards the monitoring indications; there were increases for nursing fluid balance completed from 19% to 46%, blood glucose taken and recorded from 64% to 83% and the daily weight documented from 10% to 49%.ConclusionsThis short QI project shows that implementation of an intervention did improve outcomes across all indications investigated. The results are not as dramatic as first hoped, but this is largely due to the short time scale of 4 weeks to introduce our change and it coincided with the change-over month of junior medical staff. With further education and champions within the medical and nursing teams; further improvement is very much possible, with the main aim in reducing risk and improving patient safety.ReferencesNational Patient Safety Alert: Reducing the risk of hyponatraemia when administering intravenous infusions to neonates 2007. Available at https://www.sps.nhs.uk/articles/npsa-alert-reducing-the-risk-of-hyponatraemia-when-administering-intraveneous-infusions-to-neonates/ [Accessed 12th June 2019]NICE guidance: Intravenous fluid therapy in children and young people in hospital. Available at https://www.nice.org.uk/guidance/ng29 [Accessed 12th June 2019]
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Luce, Cate, Rosie Soffair, and Andy Parrish. "Improving intravenous fluid prescribing in the Eastern Cape in South Africa." BMJ Open Quality 8, no. 3 (August 2019): e000406. http://dx.doi.org/10.1136/bmjoq-2018-000406.

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Intravenous fluids are an essential component of patient care, but a 2013 National Institute for Health and Care Excellence (NICE) guideline noted that inappropriate prescribing or administration may lead to actual or potential patient harm in up to 20% of patients.1 This project aimed to improve prescribing documentation and communication between nurses and doctors regarding intravenous fluid management. This was done through the introduction of a fluid chart, in combination with teaching on appropriate fluid management. It was initiated within the medical department of Cecelia Makiwane Hospital in East London, South Africa. 309 patients were included and data were analysed over a 6-month period. The outcome measures were the standards of intravenous fluid prescribing set by the NICE guidelines. The process measure was the use of the new chart. Baseline data highlighted that there was no standardised location for fluid prescriptions within the bedside notes. Following the intervention, 81% of fluid prescriptions were on a fluid chart. The percentage of fluid scripts with a 24-hour fluid prescription, a recorded indication and recorded input increased after the intervention. Seventy six per cent of patients received more than 50% of the fluids prescribed following the intervention compared with 22% at baseline. These results indicated an increase in the doctor’s awareness of appropriate fluid prescribing and an improvement in the communication between doctors and nurses regarding the patient’s fluid management. The engagement of local stakeholders and staff was fundamental to the success of the project and allowed for this change in practice. Fluid management is a vital part of care in many specialties; therefore, a toolkit has been created to allow similar quality improvement projects to be implemented across other hospitals around the Eastern Cape.
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Grace, Allport, and Playfor Stephen. "P12 Factors affecting intravenous fluid bolus administration in paediatrics." Archives of Disease in Childhood 103, no. 2 (January 19, 2018): e1.16-e1. http://dx.doi.org/10.1136/archdischild-2017-314584.23.

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AimBolus administration of 0.9% sodium chloride solution has been associated with hyperchloraemia, acidosis, acute kidney injury and increased mortality. Such adverse effects are believed to be less likely with balanced electrolyte solutions, such as Plasma- Lyte 148 or Hartmann’s solution. Despite existing evidence, 0.9% sodium chloride solution remains a popular choice for intravenous fluid boluses in paediatrics. This project aims to establish current practice of fluid bolus administration in paediatric patients, and to collect testimony from prescribers to help understand why decisions to prescribe specific fluids were made.MethodPaediatric patients in critical care areas (PICU and PHDU), the Emergency Department (PED) and in general ward areas who had been administered intravenous fluid boluses were identified using a pragmatic data collection technique and the dose, type of fluid, indication and patient’s weight were recorded. Where possible, the prescriber was identified and asked to be interviewed. Prescribers were asked what factors had affected their decision to prescribe the type and dose of fluid administered.ResultsMore than 30 individual episodes of intravenous fluid bolus administration were identified. Most fluid boluses were administered in PICU and PHDU, where balanced electrolyte solutions, specifically Plasma-Lyte 148, were the most popular choice. On general paediatric wards and in PED, 0.9% sodium chloride solution remained the most commonly administered fluid bolus solution. While some prescribers were able to give confident explanations of the factors involved in fluid selection, others referred to clinical guidelines. Individual prescribers described how their prescribing practice would vary according to the clinical setting; with senior clinicians and nursing staff being less accepting of balanced electrolyte solutions in general ward areas. Significant lack of knowledge of intravenous fluid physiology was demonstrated by some prescribers.ConclusionOur findings demonstrate an increase in the administration of balanced electrolyte solutions, such as Plasma-Lyte 148, as fluid boluses; this is in keeping with other international surveys of fluid administration.1,2 Similarly, we have also found significant differences in fluid bolus administration practice across different clinical areas as demonstrated by Jonsson and Perner in 2017.We have demonstrated the importance of on-going multi-disciplinary educational efforts in continuing the evolution of intravenous fluid bolus administration practice to reflect current best practice.ReferencesHammond NE, Taylor C, Finfer S, et al. Patterns of intravenous fluid resuscitation use in adult intensive care patients between 2007 and 2014: An international cross-sectional study. PLoS One2017;12:e0176292.Jonsson AB, Perner A. Changes from 2012 to 2015 in intravenous fluid solutions issued to hospital departments. Acta Anaesthesiol Scand2017;61:532–538.
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Kuensting, Laura L. "Comparing Subcutaneous Fluid Infusion with Intravenous Fluid Infusion in Children." Journal of Emergency Nursing 39, no. 1 (January 2013): 86–91. http://dx.doi.org/10.1016/j.jen.2012.04.017.

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Gaut, Daria, Jennifer Jones, Caroline Chen, Sanaz Ghafouri, Mei Ling, and Roswell Quinn. "Outcomes Related to Intravenous Fluid Administration in Sickle Cell Patients during Vaso-Occlusive Crisis." Blood 134, Supplement_1 (November 13, 2019): 992. http://dx.doi.org/10.1182/blood-2019-121945.

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Introduction Fluid replacement therapy is often used as a primary treatment modality in vaso-occlusive crises for sickle cell disease. However, aggressive intravenous fluid administration can lead to complications, including pulmonary vascular congestion and acute chest syndrome. Data is limited on the safety, efficacy, and variability of fluid replacement therapy in this context. This study describes the extent of and outcomes associated with receiving fluid replacement therapy for vaso-occlusive episodes at a single institution. Methods We performed a retrospective analysis on 157 unique patient encounters from 49 sickle cell patients hospitalized with a vaso-occlusive episode at the University of California Los Angeles between 2013 and 2017. Fluid administration measurements were derived from documented intakes (both oral and intravenous fluids) in the medical record. The association between fluid administration and outcomes were analyzed using chi-squared and Fisher's exact tests followed by univariate and multivariate logistic regression. Results The mean age of the patient cohort at the time of hospital admission was 36.0 years (Std 7.9). Most encounters were from patients with hemoglobin SS disease (147 encounters, 93.6%). Twenty-two of the encounters (14.0%) were from patients on hemodialysis prior to admission. The majority of admissions were to an observation unit (99 encounters, 63.1%), whereas 53 admissions (33.8%) were to an inpatient service and 5 encounters (3.2%) were solely in the emergency room. The median length of hospital stay was 4 days (IQR 2-7). The mean total amount of intravenous fluid administered during the hospitalization was 7.4 L (Std 9.6). The mean total amount of fluid intake including intravenous fluids, blood transfusions, and oral fluids was 6.5 L (Std 10.0) (Table 1). The most common clinical outcome that occurred during the hospitalizations was a new oxygen requirement in 28 encounters (17.8%). Other clinical outcomes noted were acute chest syndrome (12 encounters, 7.6%), an aspiration event (2 encounters, 1.3%), other type of hospital-acquired infection (2 encounters, 1.3%, which included Clostridium difficile colitis and Staphylococcus epidermidis bacteremia), acute kidney injury (3 encounters, 1.9%), and intensive care unit transfer (3 encounters, 1.9%). There was a significant association between receiving more than 3 L of intravenous fluid and the development of any of the adverse events listed (p = 0.029) but no association between fluid administration and each individual adverse event (Table 2). Logistic regression analysis confirmed that patients with higher fluid intake were more likely to develop any adverse event (Table 3, Table 4). In multivariable analysis, each component including oral intake during hospitalization (p = 0.041, OR 1.065, 95% CI 1.003-1.132), intravenous fluid administered in the first 24 hours (p = 0.001, OR 1.899, 95% CI 1.319-2.733), total amount of intravenous fluid administered (p = 0.005, OR 1.081, 95% CI 1.023-1.141), and total amount of fluid intake (p = 0.040, OR 1.065, 95% CI 1.003-1.132) all revealed a statistically significant association between higher fluid administration and the development of any adverse event. Other factors found to be significantly associated with any adverse event were dialysis dependence prior to admission (p = 0.000, OR 8.686, 95% CI 2.881-26.190) and admission to inpatient service versus emergency room or observation unit (p = 0.018, OR 2.758, 95% CI 1.186-6.416). Conclusions There was a statistically significant association between higher fluid intake (both oral and intravenous) and the development of any adverse event during hospitalization for sickle cell vaso-occlusive crisis including a new oxygen requirement, acute chest syndrome, aspiration event, other hospital-acquired infection, acute kidney injury, and intensive care unit transfer. While fluid administration may theoretically slow the sickling process, our data suggests that excessive fluid administration during a vaso-occlusive episode may be harmful. Further study is necessary to further elucidate the relationships between exogenous fluids, vaso-occlusion, and adverse events in sickle cell patients. *Equal contribution from Daria Gaut and Jennifer Jones for this work. Disclosures No relevant conflicts of interest to declare.
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Noonpradej, Seechad, and Osaree Akaraborworn. "Intravenous Fluid of Choice in Major Abdominal Surgery: A Systematic Review." Critical Care Research and Practice 2020 (August 3, 2020): 1–19. http://dx.doi.org/10.1155/2020/2170828.

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Background. Intravenous fluid therapy plays a role in maintaining the hemodynamic status for tissue perfusion and electrolyte hemostasis during surgery. Recent trials in critically ill patients reported serious side effects of some types of fluids. Since the most suitable type of fluid is debatable, a consensus in perioperative patients has not been reached. Method. We performed a systematic review of randomized control trials (RCTs) that compared two or more types of fluids in major abdominal surgery. The outcomes were related to bleeding, hemodynamic status, length of hospital stay, and complications, such as kidney injury, electrolyte abnormality, major cardiac adverse event, nausea, vomiting, and mortality. A literature search was performed using Medline and EMBASE up to December 2019. The data were pooled to investigate the effect of fluid on macrocirculation and intravascular volume effect. Results. Forty-three RCTs were included. Eighteen fluids were compared: nine were crystalloids and nine were colloids. The results were categorized into macrocirculation and intravascular volume effect, microcirculation, anti-inflammatory parameters, vascular permeability, renal function (colloids), renal function and electrolytes (crystalloids), coagulation and bleeding, return of bowel function, and postoperative nausea vomiting (PONV). We found that no specific type of fluid led to mortality and every type of colloid was equivalent in volume expansion and did not cause kidney injury. However, hydroxyethyl starch and dextran may lead to increased bleeding. Normal saline can cause kidney injury which can lead to renal replacement therapy, and dextrose fluid can decrease PONV. Conclusion. In our opinion, it is safe to give a balanced crystalloid as the maintenance fluid and give a colloid, such as HES130/0.4, 4% gelatin, or human albumin, as a volume expander.
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Arora, Sanjay, Marc A. Probst, Laura Andrews, Marissa Camilion, Andrew Grock, Gregory Hayward, and Michael Menchine. "A randomized, controlled trial of oral versus intravenous fluids for lowering blood glucose in emergency department patients with hyperglycemia." CJEM 16, no. 03 (May 2014): 214–19. http://dx.doi.org/10.2310/8000.2013.131082.

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ABSTRACT Objectives: Blood glucose can be lowered via insulin and/or fluid administration. Insulin, although efficacious, can cause hypoglycemia and hypokalemia. Fluids do not cause hypoglycemia or hypokalemia, but the most effective route of fluid administration has not been well described. This study compared the efficacy and safety of oral versus intravenous fluids for reducing blood glucose in patients with hyperglycemia. Methods: We conducted a prospective, nonblinded, randomized, controlled trial. Inclusion criteria were blood glucose &gt; 13.9 mmol/L, age &gt; 18 years, and ability to tolerate oral fluids. Subjects were excluded for critical illness, contraindication to fluids, and/or hyperglycemia therapy prior to enrolment. Subjects were randomized to receive oral bottled water or intravenous normal saline (maximum 2 L) over 2 hours. The primary outcome of interest was a change in blood glucose at 2 hours across treatment arms. Results: The 48 subjects were randomized. Baseline blood glucose levels and total amount of fluid received were similar between the two groups. The mean decrease in blood glucose at 2 hours was similar for both treatment arms: a mean decrease of 3.4 mmol/L (20.2 mmol/L to 16.8 mmol/L) in the oral fluid group versus a mean decrease of 4.0 mmol/L (19.7 mmol/L to 15.7 mmol/L) in the intravenous fluid group. The mean difference between groups was −0.6 mmol/L (95% confidence interval −2.3–1.2; p = 0.51). No adverse events were observed in either group. Conclusion: In this unblinded randomized trial, oral and intravenous fluids were equally efficacious in lowering blood glucose levels in stable hyperglycemic patients and no adverse events were noted. Physicians should be mindful that, although similar, the reduction in blood glucose was modest in both groups.
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Wardani, Citra Kusuma. "Design of Arduino-Based Periodic Cycle Drip Monitoring System on the Web." Jurnal Jartel: Jurnal Jaringan Telekomunikasi 7, no. 2 (November 1, 2018): 20–26. http://dx.doi.org/10.33795/jartel.v7i2.174.

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Giving intravenous fluids is very useful to support and accelerate the recovery of the patient's condition during the healing period. Problems in handling can have a negative impact on patients who are currently monitoring intravenous fluids using a manual system. To reduce the adverse effects on patients is to design an arduino-based intravenous fluid monitoring tool. The design of this tool is a way of monitoring that can be done at a distance. This tool aims to provide a warning when the intravenous fluid will run out (Â ± 100 ml) using a weight sensor, detect the drip stop using the ldr sensor and detect the intravenous entering the infusion tube using a photodiode. The value obtained from a sensor will be received by Arduino NodeMCU . Then Arduino will send the value which goes to the database then from the database it will enter the web monitoring. Where the web monitoring is in the nurse's room which monitors intravenous fluids remotely. The data from the heavy sensor has 95% accuracy because the data obtained is not affected by conditions from outside the sensor, while the photodiode and LDR data have 90% accuracy because these two sensors are light sensors that can be affected by light from outside.
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