IV Fluid management: saving millions of dollars in operating costs by improving patient outcomes

Imagine your hospital significantly optimizing patient throughput, reducing the risk of mechanical ventilation and the need for acute dialysis treatment -- while saving millions of dollars in operating costs.

Mounting clinical and economic evidence shows that all these may be achieved through closer attention to what’s typically the first line of care in a hospital: intravenous (IV) fluid management.

The Hidden Benefits of IV Fluid Management
Over 80 percent of hospitalized patients receive IV fluid. IV fluids meet many patient needs: keeping patients hydrated, replenishing critical electrolytes and serving as delivery vehicles for other medications. At times, fluids are given rapidly and in large amounts to address blood pressure and perfusion issues. In these instances, fluids can be life-sustaining, but if over used, they can also cause complications, especially in hemodynamically unstable patients such as those with sepsis.

Increasingly, clinicians are adopting dynamic measures such as passive leg raises (PLRs) to guide dosing of IV fluid, with positive results. A PLR translocates 250-300 ml of a patient’s own blood from the patient’s legs to the heart to challenge the heart so doctors can observe its response. If cardiac output increases by more than 10 percent, it is likely that the patient is responsive to fluid, and that additional volume can be delivered safely. By using Cheetah Medical’s new non-invasive hemodynamic monitoring technology, physicians and nurses administering PLRs can have real-time demonstration of a patient’s fluid responsiveness. This is especially important in ICUs, emergency departments and other critical care situations when physicians need all relevant patient data to guide their decision-making.

Major Economic Benefits
Sepsis costs the U.S. healthcare system nearly $24 billion annually and is the second leading cause of death in non-coronary ICUs with a mortality rate of 45 percent.1 Treating sepsis costs approximately $25,000 – $50,000 per episode.2

A 2017 study of severe sepsis and septic shock patients, led by researchers from the University of Kansas Health System, demonstrated strong clinical and economic value for fluid resuscitation strategies using dynamic assessments of stroke volume change. Among the findings were a 2.89-day reduction in ICU length of stay, a 51 percent reduction in the risk of mechanical ventilation and a 13.25 percent reduction in the initiation of acute dialysis therapy. The researchers estimated that the avoidance of these costly interventions represented savings of $14 million annually.

Proper IV fluid management is an essential line of care for millions of critically ill patients. Dynamic tools such as PLRs along with novel monitoring technology can provide doctors with essential information about patient fluid response that can be evaluated in real-time throughout the patient’s hospital stay. Hospital administrators can realize significant clinical and health economic benefits by employing protocols using stroke volume changes to inform decisions about the use of IV fluid in the care of critically ill patients.

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Chris Hutchison is president and CEO of Cheetah Medical, a pioneer and leading global provider of 100 percent non-invasive fluid management monitoring technologies, designed for use in critical care, operating room and emergency department settings. For more information, please visit: www. Cheetah-medical.com.

 

1. https://www.sepsis.org/sepsis-alliance-news/new-u-s-government-report-reveals-annual-cost-of-hospital-treatment-of-sepsis-has-grown-by-3-4-billion/
2. Martin GS. Sepsis, severe sepsis and septic shock: changes in incidence, pathogens and outcomes. Expert Rev Anti Infect Ther 2012; 10(6) 701-706.

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