The Ottawa Hospital General Campus to be a test ground to compare two rehydration fluids

August 11, 2016

Starting August 2016, a pilot study at the General Campus of The Ottawa Hospital will help find out which of two liquids is the best to replace lost fluids in hospitalized patients.

A healthy person’s bodyweight is about 60 percent water. However, some of that water is lost during profuse sweating, bleeding, diarrhea, infection or surgery. Doctors and nurses use special fluids to bring a patient’s water volume back to normal. Two of the most common are normal saline solution and Ringer’s Lactate solution. Over 19 million bags of these fluids are used every year in Ontario.

Dr. Lauralyn McIntyre is conducting a study to answer a decades-old question: which of these two solutions is better for hospitalized patients? Currently, there is no strong evidence in favour of one over the other.

“These fluids are widely used in hospitals across Canada,” said Dr. McIntyre, an intensive care physician and senior scientist at The Ottawa Hospital, and associate professor at the University of Ottawa. “This means that even if we find very small differences in outcomes, such as deaths or re-admissions to hospital, they could translate into significant benefits for patients and the health-care system.”

Usually a doctor puts in an order to give a patient a particular fluid, and a nurse will administer that fluid. However, during a pilot trial at the General Campus of The Ottawa Hospital beginning in August 2016, things will be a bit different. For three months the campus will exclusively use either Ringer’s Lactate or Normal Saline solution. Then, after a month of using both fluids, the campus will switch to the other solution for three months.

The Ottawa Hospital’s Medical Advisory Committee has given nurses the authority to automatically substitute a solution unless the treating physician writes a ‘no substitution order.”

The trial, called FLUID, will include patients treated in the emergency department, inpatient units, perioperative areas, and the intensive care unit. Outpatients in the hospital’s clinics and newborns will not be part of the trial.

Data will come from Ontario’s Institute for Clinical Evaluative Sciences, which routinely collects anonymous information about patient outcomes for quality assurance of the health-care system. The research team will compare the two solutions based on readmission to hospital or visits to an emergency department within 90 days, need for dialysis, need for re-operation, length of hospital stay and mortality. They will also analyze the results by patient age, sex, type of admission and type of surgery.

“This research has great potential to improve care for patients at The Ottawa Hospital and around the world,” said Dr. Duncan Stewart, Executive Vice-President of Research and senior scientist at The Ottawa Hospital, and professor at the University of Ottawa. “While it will require cooperation on the part of many hospital staff, I’m confident that everyone will come together to help answer this important question.” Because both fluids are used interchangeably as part of standard care, patients will not be asked to sign a consent form to participate.

This trial has been approved by the Ottawa Health Science Network Research Ethics Board.

This study is funded by the Canadian Institutes of Health Research and TOHAMO.

Local co-investigators: Andrew Seely, Ian Stiell, Shane English, Raphael Saginur, Dean Fergusson, Kednapa Thavorn, C. McCartney, Monica Taljaard, Steven Hawken, A. Iyengar, . K. Kyeremanteng, A. Forster, I. Graham

If hospital employees have questions about the study, please contact Tracy McArdle or Dr. Lauralyn McIntyre.

If patients or media have questions about the study, please contact:

Amelia Buchanan
Senior Communications Specialist
Ottawa Hospital Research Institute
Office: 613-798-5555 ext. 73687
Cell: 613-297-8315

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