IV crystalloid fluid for acute alcoholic intoxication prolongs ED length of stay

Homma, Yosuke; Shiga, Takashi; Hoshina, Yuiko; Numata, Kenji; Mizobe, Michiko; Nakashima, Yoshiyuki; Takahashi, Jin; Inoue, Tetsuya; Takahashi, Osamu; Funakoshi, Hiraku

doi:10.1016/j.ajem.2017.12.054

Cited by 6 publications

(20 citation statements)

References 25 publications

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“…The observation protocol with the shorter intervals increased the accuracy of evaluation of the IVF effect. Third, patients with minor trauma were also included, and BAC was measured in all cases, which would have better external validity than that in the previous studies (8,9). Fourth, in this study, we performed analyses considering patients' ability to metabolize alcohol.…”

Section: Discussionmentioning

confidence: 99%

“…Two studies showed that IVF therapy did not shorten the length of stay in the ED (8,9). However, information on the effectiveness of IVF therapy for acute alcohol intoxication is insu cient for the following reasons due to measurement msr4y6ethod.…”

Section: Discussionmentioning

confidence: 99%

“…In subgroup analysis, 42 patients were included, of whom 28 received IVF and 14 did not. There was a signi cant difference in the GCS score at the scene (8 [IQR,8] Table S1). There were 66 eligible patients who did not participate, and 53 were excluded owing to protocol violation ( Fig.…”

Section: Participantsmentioning

confidence: 99%

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Effect of Intravenous Fluid Therapy for Acute Alcohol Intoxication on Length of Time from Arrival at the Emergency Department until Awakening: A Prospective Observational Cohort Study

Terayama

Sasa

Nakatani

et al. 2021

Preprint

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Background Acute alcohol intoxication is a common condition observed in the emergency department (ED). Intravenous fluid therapy (IVF) is often administered to treat this condition, but its effectiveness remains unclear. We therefore conducted a study to evaluate the effect of IVF on length of time from arrival at the ED until awakening, which is a novel and more appropriate variable. Methods This single-center, prospective observational study was conducted in the ED of Self-Defense Forces Central Hospital, a secondary emergency hospital in Tokyo from October 1, 2018 to July 31, 2019. Patients were assigned to groups to receive either a 1,000-mL bolus of lactated Ringer’s solution or only cannulation. The primary outcome was length of until awakening. Secondary outcomes were length of stay in the ED and the occurrence of conditions requiring extra care. Univariate and multivariate regression analyses were performed. Predictors of the occurrence of any event that required extra care were identified using a statistical model. Results The final sample included 201 patients: 109 received IVF and 92 did not. There was no significant difference in baseline characteristics between the groups. Median length of time until awakening was 211 min (interquartile range [IQR], 119 min) in the IVF group and 208 min (IQR, 149 min) in the non-IVF group (p = 0.77). Multivariate regression analysis demonstrated that the regression coefficient of IVF for length of time until awakening was − 9.55 (95% confidence interval [CI], \(-\)36.2 to 17.2). However, hemoglobin (regression coefficient, \(10.1\); 95% CI, \(0.38\)-19.9) and initial Glasgow Coma Scale score (GCS) in the ED (regression coefficient, \(-\)7.51; 95% CI, \(-\)10.8 to \(-\)4.21) were significantly associated with length of time. Conclusions This is the first study to evaluate the effect of IVF therapy on the length of time until awakening. IVF therapy is not effective in shortening the length of time in patients with acute alcohol intoxication in the ED. Routine administration of IVF is unnecessary in these patients. Further research is warranted to investigate who benefit from IVF therapy. A significance difference in Hb and GCS in this study also would give useful tips for the next study.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Effect of Intravenous Fluid Therapy for Acute Alcohol Intoxication on Length of Time from Arrival at the Emergency Department until Awakening: A Prospective Observational Cohort Study

Terayama

Sasa

Nakatani

et al. 2021

Preprint

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“…The length of stay of the patient with acute alcohol intoxication (AAI) in the emergency department (ED-LOS) can be affected by many variables such as the use of diagnostic testing, the need for treatments [38], the hour of arrival [37], and the involuntary holds [35,40].…”

Section: Discussionmentioning

confidence: 99%

“…For example, a recent retrospective, multi-center, observational study reported that variables such as diagnostic testing, treatments, and hour of arrival may influence and prolong the length of stay at the ED in patients with acute ethanol intoxication [37]. Also, intravenous crystalloid fluid for acute intoxication can prolong the length of stay at the ED [38].…”

Section: The Importance Of Temporary Observation Unit In the Emergencmentioning

confidence: 99%

Risk Management in First Aid for Acute Drug Intoxication

Piccioni

Cicchinelli

Saviano

et al. 2020

IJERPH

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Drug abuse (cannabis, cocaine, opiates, and synthetic drugs) is an increasing phenomenon, especially in the younger population, thus leading to more cases of intoxication requiring evaluation in the emergency department and subsequent hospitalization. In 2017, 34.2% of students reported having used an illegal psychoactive substance in their lifetime, while 26% reported having done so over the past year. We made a review about the effectiveness of the role of the temporary observation unit in the emergency department to improve management of acute drugs intoxication. We checked medical literature from the last 10 years (2009–2019). The following electronic databases were systematically searched: MEDLINE-PubMed, Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials. Then, a systematic review was carried out according to the Preferred Reporting Items for Systematic Review standards. Intoxicated patients usually display a favorable medical course, few diagnostic and therapeutic interventions, a short stay in the hospital, and, when hospitalization is needed, semi-intensive therapy is a feasible solution; therefore, intoxicated patients are ideal candidates for a temporary observation unit. The emergency department is very important to manage intoxicated patients; however, the hospitalization of these patients is often not necessary.

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Effect of intravenous fluid therapy for acute alcohol intoxication on length of time from arrival at the emergency department until awakening: A prospective observational cohort study

Terayama

Sasa

Nakatani

et al. 2023

Acute Medicine & Surgery

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AimTo evaluate the association of intravenous fluid (IVF) therapy on the length of time from arrival at the emergency department (ED) until awakening in cases of acute alcohol intoxication.MethodsThis single‐center, prospective, observational study was conducted in the ED of the Self‐Defense Forces Central Hospital during October 1, 2018 to July 31, 2019. Patients with 1,000 mL bolus of lactated Ringer's solution and those without bolus were compared. The primary outcome was the length of time until awakening. Secondary outcomes were the length of stay in the ED and occurrence of conditions requiring extra care. Predictors of the occurrence of any event requiring extra care were identified.ResultsWe included 201 patients, of whom 109 received IVF and 92 did not. No significant difference existed in the baseline characteristics between the groups. The median length of time until awakening did not significantly differ between the groups (P = 0.77). Multivariable regression analysis adjusted by age, sex, hemoglobin, blood alcohol concentration, and initial Glasgow Coma Scale (GCS) score demonstrated that the regression coefficient of IVF for length of time until awakening was −9.55 (95% confidence interval [CI], −36.2 to 17.2). Hemoglobin (regression coefficient, 10.1; 95% CI, 0.38–19.9) and initial GCS score (regression coefficient, −7.51; 95% CI, −10.8 to −4.21) were significantly associated with length of time.ConclusionIVF therapy was not associated with the length of time until awakening in patients with acute alcohol intoxication in the ED. Routine IVF administration was unnecessary.

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IV crystalloid fluid for acute alcoholic intoxication prolongs ED length of stay

Cited by 6 publications

References 25 publications

Effect of Intravenous Fluid Therapy for Acute Alcohol Intoxication on Length of Time from Arrival at the Emergency Department until Awakening: A Prospective Observational Cohort Study

Effect of Intravenous Fluid Therapy for Acute Alcohol Intoxication on Length of Time from Arrival at the Emergency Department until Awakening: A Prospective Observational Cohort Study

Risk Management in First Aid for Acute Drug Intoxication

Effect of intravenous fluid therapy for acute alcohol intoxication on length of time from arrival at the emergency department until awakening: A prospective observational cohort study

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