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Saltier IV Fluids can lower risk of Surgical Complications

Update Date: Jul 15, 2014 01:51 PM EDT

Even though surgical procedures are done to save lives, the complications that arise afterwards can become life threatening. In a new study, researchers from Thomas Jefferson University in Philadelphia, PA set out to see if saltier intravenous fluids could improve the surgical patients' outcomes. The team found that using a saltier saline drip that has a lower total volume of fluid during surgery could reduce the risk of complications that arise post-surgery.

"This relatively minor change in intravenous fluids has had a tremendous effect on the overall complication rate for our patients," stated first author Harish Lavu, M.D., Associate Professor of Surgery at Thomas Jefferson University reported in the press release. "Based on these findings we have already changed our practice in the operating room to use hypertonic saline."

During surgery, a saline drip helps provide adequate hydration for the patient. However, evidence from other studies have hinted that finding the right balance of water and salt can have a beneficial impact on patients' recovery. For this study, the team recruited 264 patients who had to undergo the Whipple operation, which is a five to nine hour-long procedure for pancreatic cancer. 128 patients were randomly assigned to receive standard IV fluid while the remaining 131 patients were given the saltier drip, also known as hypertonic saline.

The researchers discovered that patients who received the hypertonic saline had a 25 percent decrease in surgical complications. In terms of numbers, only 93 patients from the hypertonic saline group suffered from complications whereas in the standard IV group, 123 patients experienced complications. Based from these findings, the researchers at the University have already changed their standard IV drip.

"We are confident that this change in our surgical process will help our patients recover faster with fewer complications," stated senior author Charles J. Yeo, M.D., The Samuel D. Gross Professor and Chair of the Department of Surgery at Thomas Jefferson University.

The researchers explained that increasing salt in the drip helps maintain the patients' fluid balance as well as blood pressure. The extra salt also reduces liquid buildup in the lungs, interstitial spaces and swelling in the extremities.

The study, "The HYSLAR trial: A prospective randomized controlled trial of the use of a restrictive fluid regimen with 3% hypertonic saline (HYS) versus lactated ringers (LAR) in patients undergoing pancreaticoduodenectomy," was published in the Annals of Surgery.

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