The Prevalence and Indications of Intravenous Rehydration Therapy in Hospital Settings: A Systematic Review

Abstract

(1) Objective: We performed a systematic review to explore the prevalence of intravenous (IV) rehydration therapy in hospital settings, and we assessed it by patient groups and populations. (2) Methods: A systematic review of major databases and grey literature was undertaken from inception to 28 March 2022. Studies reporting prevalence of IV rehydration therapy in a hospital setting were identified. The data were synthesised in a narrative approach. (3) Results: Overall, 29 papers met the inclusion criteria. The prevalence of IV rehydration therapy in paediatric patients ranged from 4.5% (hospitalised with diarrhoea and dehydration) to 100% (admitted to the emergency department with mild to moderate dehydration caused by viral gastroenteritis), and in adults this ranged from 1.5% (had single substance ingestion of modafinil) to 100% (hospitalised with hypercalcemia). The most common indication for IV rehydration therapy in paediatric patients was dehydration due to fluid loss from the gastrointestinal tract. Other causes included malnutrition, neuromuscular disease, bronchiolitis, and influenza. In adults, indications for IV rehydration therapy were much more diverse: fever, diarrhoea, drug intoxication, hypercalcemia, cancer, and postural tachycardia syndrome; (4) Conclusions: This systematic review showed that IV rehydration therapy in paediatric patients is often used to treat dehydration and diarrhoea, while in adults it has a broader spectrum of use. While IV rehydration therapy is important in correcting fluid problems and electrolyte status, the maintenance fluid prescribing practices vary considerably, and guidelines are scarce.

Treatment of Acute Diarrhea in Children Aged 1–5 Years Provided by Doctors in Surabaya

“…However, the most common method of rehydration used was intravenous rehydration. Intravenous fluids are so common in hospitals that it is easy to overlook the signs of patients who require them (Toaimah & Mohammad 2016, Gawronska et al 2022. Many doctors prefer intravenous rehydration because oral rehydration therapy requires more time.…”

“…In oral rehydration therapy, the patient requires an extended stay in the emergency unit, while the staff requires longer working time. The fact that some respondents in a study worked in the emergency unit and inpatient ward made them prefer intravenous rehydration in the emergency unit (Gawronska et al 2022).…”

“…Intravenous fluids have the advantage of being able to be administered directly into the bloodstream. Therefore, time delays that can occur with oral rehydration procedures can be eliminated (Gawronska et al 2022). Another reason that leads to the widespread use of intravenous rehydration is a fault in the initial assessment of the patient's dehydration degree.…”

Thick Liquids and Clinical Outcomes in Hospitalized Patients With Alzheimer Disease and Related Dementias and Dysphagia

“…However, this could be because patients commonly receive intravenous fluids throughout their hospital stay. 50,51 Lastly, it is important to note that given the wide 95% CIs for outcomes, such as mortality, clinically meaningful differences cannot be excluded. Ultimately, given these mixed results, prospective studies are needed to determine which patients with ADRD and dysphagia benefit most from thick liquids.…”

“…Unlike previous studies, we did not find differences between thin and thick liquids with regard to dehydration. However, this could be because patients commonly receive intravenous fluids throughout their hospital stay . Lastly, it is important to note that given the wide 95% CIs for outcomes, such as mortality, clinically meaningful differences cannot be excluded.…”