Issuing of isotonic crystalloid solutions to Danish public hospitals in 2021-A retrospective nationwide observational study.

BACKGROUND: Intravenous (IV) fluid therapy is a ubiquitous intervention in daily clinical practice. However, nationwide detailed hospital- and departmental-level information on IV fluid use is limited. Hence, we aimed to describe the current issuing of isotonic crystalloid solutions across Danish public hospitals. METHODS: We conducted a nationwide, retrospective observational study describing the issuing of isotonic crystalloid solutions for IV administration, including 0.9% saline, acetate- and lactate-buffered crystalloid solutions. We assessed fluid issuing at national-, regional-, hospital- and departmental-level from 1 January 2021 to 31 December 2021. We obtained sales figures from the Danish Regional Hospital Pharmacies. Regional characteristics were acquired from the Danish Health Data Authorities online resources. Results are presented graphically and descriptively, including frequencies (%). RESULTS: The total amount of isotonic crystalloid solutions issued across Danish public hospitals in 2021 was 1,487,144 L (67.4% saline, 25.9% acetate- and 6.7% lactate-buffered solutions) equivalent to 2.1 L per hospitalised patient within the study period. Both the issuing of saline versus. buffered crystalloid solutions and the issuing of acetate- versus lactate-buffered solutions varied across geographical regions. Medical departments used saline more frequently (85.3%) than emergency departments (71.5%), surgical departments (70.6%) and anaesthesiological departments including intensive care units (43.0%). CONCLUSIONS: In this nationwide observational study, we found that the issuing of different isotonic crystalloid solutions varied based on geographical location. Furthermore, the issuing of different crystalloid solutions differed across departmental settings with medical departments using the highest proportion of saline and anaesthesiological departments using the highest proportion of buffered crystalloid solutions. EDITORIAL COMMENT: IV fluid administration practices can be assessed across specialties by examining hospital purchasing. This study analysed the use of IV isotonic crystalloid solutions across all major departments of Danish public hospitals for 1 year. Isotonic sodium chloride was the most commonly used fluid in emergency medicine (71%), internal medicine (85%) and surgical departments (71%). Only anaesthesia and intensive care medicine departments used more buffered crystalloid solutions (57%) than isotonic natrium chloride.

Use of crystalloids and colloids in Europe per year from 2010 to 2019: Protocol for an international descriptive study.

INTRODUCTION: Intravenous (IV) fluids are widely used in everyday clinical practice. In the last two decades, several trials and clinical practice guidelines have been published on the use of different types and dosages of IV fluid. This may have led to a change in clinical practice. Thus, we aim to describe the use of IV crystalloids and colloids in Europe over a 10-year period. METHODS AND ANALYSIS: We will collect national or regional data on the use of IV crystalloids and colloids in European hospitals through companies and/or federal medical agencies that provide pharmaceutical data concerning the type and amount of fluids used from January 1st, 2010 to December 31st, 2019. We will use run charts to describe time trends in the use of fluids. CONCLUSION: This study will provide insight into the use of IV fluids in Europe between 2010 and 2019. It will enable the observation of changes over time and among the different European countries and regions. This will provide information on the extent to which landmark trials and clinical practice guidelines on fluids have affected clinical practice in Europe regarding the use of IV fluids.