Could patient-controlled fluid administration lead to more rapid rehydration?

6th Feb 2018

Xtreme Everest's Prof Monty Mythen and Prof Hugh Montgomery are authors on a recent paper featured in the British Journal of Anaesthesia which looks at fluid management, and in particular focuses on a feasibility study undertaken to look at patient vs clinician directed fluid administration.

The paper entitled Could patient-controlled thirst-driven fluid administration lead to more rapid rehydration than clinician-directed fluid management? An early feasibility study looks at the study which was undertaken the ISEH where 16 healthy male volunteers were tested. In total there was 19 volunteers, but two did not meet the inclusion criteria and one dropped out due to time constraints.

Twice the volunteers took oral furosemide, along with a 12 hour oral fluid restriction before attending the lab where they were given a 4 hour i.v fluid infusion. On one visit and in the control arm i.v fluid was infused following National Institute for Health and Clinical Excellence (NICE) guidelines which was administrated by the clinician on signs of dehydration. On the other visit volunteers had control via a trigger to administer a 200ml bolus to relive their thirst. Blood and urine samples were also taken from the volunteers before and after each infusion.

Conclusions drawn from this feasibility study suggest "that thirst is sensitive to mild dehydration and appropriately subsides with i.v rehydration" and that patient controlled fluid delivery may be feasible alongside standard therapy. The group are now looking to further investigate this within a clinical perioperative setting.

You can find the paper on the BJA website here

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