ヨシダ タクオ
  吉田 拓生
   所属   医学部 医学科(東京女子医科大学病院)
   職種   講師
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Saline versus 5% dextrose in water as a drug diluent for critically ill patients: a retrospective cohort study.
掲載誌名 正式名:Journal of intensive care
略  称:J Intensive Care
ISSNコード:20520492/20520492
掲載区分国外
巻・号・頁 8,pp.69
著者・共著者 Aoyagi Yukari, Yoshida Takuo, Uchino Shigehiko, Takinami Masanori, Uezono Shoichi
担当区分 2nd著者
発行年月 2020
概要 Background:The choice of intravenous infusion products for critically ill patients has been studied extensively because it can affect prognosis. However, there has been little research on drug diluents in this context. The purpose of this study is to evaluate the impact of diluent choice (saline or 5% dextrose in water [D5W]) on electrolyte abnormalities, blood glucose control, incidence of acute kidney injury (AKI), and mortality.Methods:This before-after, two-group comparative, retrospective study enrolled adult patients who stayed for more than 48 h in a general intensive care unit from July 2015 to December 2018. We changed the default diluent for intermittent drug sets in our electronic ordering system from D5W to saline at the end of 2016.Results:We included 844 patients: 365 in the D5W period and 479 in the saline period. Drug diluents accounted for 21.4% of the total infusion volume. The incidences of hypernatremia and hyperchloremia were significantly greater in the saline group compared to the D5W group (hypernatremia 27.3% vs. 14.6%, p < 0.001; hyperchloremia 36.9 % vs. 20.4%, p < 0.001). Multivariate analyses confirmed the similar effects (hypernatremia adjusted odds ratio (OR), 2.43; 95% confidence interval (CI), 1.54-3.82; hyperchloremia adjusted OR, 2.09; 95% CI, 1.31-3.34). There was no significant difference in the incidences of hyperglycemia, AKI, and mortality between the two groups.Conclusions:Changing the diluent default from D5W to saline had no effect on blood glucose control and increased the incidences of hypernatremia and hyperchloremia.
DOI 10.1186/s40560-020-00489-6
PMID 32944250