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Posted: March 01, 2018

What’s in those IV bags almost every hospital patient gets and is it dangerous?

Almost every hospital patient gets one of those IV bags filled with saline solution, but some reserachers are now questioning what’s in those bags and whether it’s dangerous for patients. Vanderbilt has already made the decision to drop saline solution, replacing it with a balanced solution instead.
New York Daily News Archive/NY Daily News via Getty Images
Almost every hospital patient gets one of those IV bags filled with saline solution, but some reserachers are now questioning what’s in those bags and whether it’s dangerous for patients. Vanderbilt has already made the decision to drop saline solution, replacing it with a balanced solution instead.

By Jason Lemon, For the Atlanta Journal-Constitution

Saline solution IV bags are one of the most common items in hospitals. But new research suggests replacing the saline with a different intravenous solution may significantly reduce the risk of death and kidney damage in patients.

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According to the study, which was discussed at a critical care conference in San Antonio and published by the New England Journal of Medicine, switching from saline could save between 50,000 and 70,000 lives in the United States every year. Ditching the common solution could also reduce cases of kidney failure by 100,000.

"We found that these balanced solutions tended to make people live longer and have less kidney damage," Dr. Wesley Self, a physician and researcher at Vanderbilt University Medical Center, who was involved in the research, told News Channel 5.

Vanderbilt has already made the decision to drop saline solution, replacing it with a balanced solution instead. The university decided to make the shift based on the new research, which found that saline has a higher concentration of sodium and chloride than blood does. On the other hand, the balanced solution is much closer to normal blood levels of sodium and chloride.

During a two-year period, Vanderbilt researchers carried out two studies involving 28,000 patients. The data collected showed that negative outcomes, such as death or kidney failure, were about one percent less likely with the balanced solution. Although the percentage may seem small, when it comes to something so common as an IV, large numbers of patients are affected.

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"When you look at the millions and millions of patients that have fluids given to them every year in the U.S., a one percent difference for each patient starts to be a big number when you multiply it out by millions," Self said.

Critical care specialists have welcomed the research, saying they have long been concerned about the potential problems of saline.

"We've been sounding the alarm for 20 years" about possible harms from saline, Dr. John Kellum, a critical care specialist at the University of Pittsburgh, who wasn't involved with the research, told CBS News. "It's purely inertia" that prevents a change, he added.

The balanced fluids now being used by Vanderbilt cost approximately the same as saline, a dollar or two per IV, meaning switching shouldn't cause any long-term financial issues for hospitals and other medical facilities, according to The Chicago Tribune.

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There has been a shortage of IV bags due to Hurricane Maria, which hit Puerto Rico hard last fall. Baxter International, one of the biggest makers of the saline fluids, had electricity cut to three of its plants on the island, temporarily halting production

"It's just really nerve-racking to think about not being able to have those bags available to the patient," Régine Villain, who manages supplies at New York University Langone Health, said about a month after the hurricane hit.

Villain also pointed out that hooking patients up to an IV is one of the most routine things health professionals do.

"[It's] the first thing we do – we use an IV, we hang an IV and that's how we start taking care of you," she said.

However, according to the new research, this simple routine action may currently be putting thousands at serious risk.

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"There are tens or hundreds of thousands of patients who would be spared death or severe kidney problems by using balanced fluids instead of saline," Dr. Matthew Semler, one of the study's leaders, said.


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