The contribution of intravenous medicines to water and sodium intake in upper and lower gastrointestinal surgical patients

Abstract Objective The quantitative importance of prescribed intravenous medicines to water and sodium intake in routine clinical practice is undocumented, with uncertain influence on clinical outcomes. The present study aimed to redress this issue in surgical patients with gastrointestinal problems. Research Methods & Procedures Prescription and administration of intravenous medicines and fluids were retrospectively reviewed for water and sodium over 24-hour periods in 86 patients in upper and lower gastrointestinal surgical wards in two teaching hospitals. Changes over five years were assessed in the same two wards using the same methodology. Results Among the 90.7% of patients prescribed intravenous medicines the median (range) intake was 272 (40–2687) mL water/day and 27 (2–420) mmol sodium/day, with no significant difference between hospitals or ward type. In 28.2% of those receiving any infusates the only source of water and sodium was intravenous medicines, and in 14.3% the medicines provided more sodium than other infusates. Antibiotics and paracetamol accounted for 58.3% of water and 52.3% of sodium in intravenous medicines. ‘Historic’ data of intravenous medicine-related salt and water intake did not differ significantly from ‘current’ data. The literature suggests clinical outcomes can be modulated by variations in water and sodium intake, are well within the range provided by intravenous medicines. Conclusions Intravenous medicine prescriptions, particularly antibiotics and paracetamol, can make substantial and clinically relevant contributions to daily water and sodium intake. They have persisted over time, and should be considered during routine assessment of fluid balance and interventions aiming to improve clinical outcomes.