Literature DB >> 11327739

Problems with solutions: drowning in the brine of an inadequate knowledge base.

D N Lobo1, M G Dube, K R Neal, J Simpson, B J Rowlands, S P Allison.   

Abstract

BACKGROUND & AIMS: We undertook a telephone questionnaire to determine current fluid prescribing practices and relevant knowledge among surgical preregistration house officers (PRHOs) and senior house officers (SHOs) working in 25 British hospitals.
METHODS: One hundred PRHOs were surveyed within 10 days of starting their first job (Group A). Fifty other PRHOs were surveyed 6-8 weeks after starting their first job(Group B) along with 50 surgical SHOs (Group C). Outcome measures included responsibility for prescribing, knowledge of the composition of common intravenous fluids and the principles governing their use.
RESULTS: PRHOs were responsible for prescribing in 89% of instances. Only 56% of respondents stated that fluid balance charts were checked on morning ward rounds. Less than half were aware of the sodium content of 0.9% saline or the daily sodium requirement. Although potassium supplements were usually correct, 25% of respondents prescribed two or more litres of 0.9% saline per day, which is far in excess of normal requirements. Although SHOs were more confident (P<0.0001), there was no significant difference between the three groups for most responses.
CONCLUSIONS: Inadequate knowledge and suboptimal prescribing of fluid and electrolytes is common. Undergraduate and postgraduate training in this basic patient management skill needs improvement, with particular emphasis on the practical aspects. Copyright 2000 Harcourt Publishers Ltd.

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Year:  2001        PMID: 11327739     DOI: 10.1054/clnu.2000.0154

Source DB:  PubMed          Journal:  Clin Nutr        ISSN: 0261-5614            Impact factor:   7.324


  28 in total

1.  Early intervention in acute renal failure: evidence of inadequate intravenous fluid treatment in UK hospitals.

Authors:  Nicholas J Matheson; Sarosh R Irani; Anushka Irani
Journal:  BMJ       Date:  2006-09-09

Review 2.  "I don't get no respect": the role of chloride in acute kidney injury.

Authors:  Joshua L Rein; Steven G Coca
Journal:  Am J Physiol Renal Physiol       Date:  2018-12-12

Review 3.  Overuse of intravenous infusions in China: focusing on management platform and cultural problems.

Authors:  Shuangshuang Zeng; Dong Wang; Wanli Liu; Yuanliang Yan; Minwen Zhu; Zhicheng Gong; Shusen Sun
Journal:  Int J Clin Pharm       Date:  2019-08-30

4.  Time to Strengthen Our Knowledge in the Areas of Acid-Base and Electrolytes.

Authors:  Qi Qian; Zhi-Hong Liu
Journal:  Kidney Dis (Basel)       Date:  2016-05-20

5.  Intravenous fluid selection rationales in acute clinical management.

Authors:  Wing Yan Shirley Cheung; Wai Kwan Cheung; Chun Ho Lam; Yeuk Wai Chan; Hau Ching Chow; Ka Lok Cheng; Yau Hang Wong; Chak Wah Kam
Journal:  World J Emerg Med       Date:  2018

Review 6.  Contemporary Approaches to Perioperative IV Fluid Therapy.

Authors:  Paul S Myles; Sam Andrews; Jonathan Nicholson; Dileep N Lobo; Monty Mythen
Journal:  World J Surg       Date:  2017-10       Impact factor: 3.352

7.  Fluid management knowledge in hospital physicians: 'Greenshoots' of improvement but still a cause for concern.

Authors:  Richard Leach; Siobhan Crichton; Neil Morton; Marc Leach; Marlies Ostermann
Journal:  Clin Med (Lond)       Date:  2020-05       Impact factor: 2.659

Review 8.  [Perioperative fluid management: an analysis of the present situation].

Authors:  Y A Zausig; M A Weigand; B M Graf
Journal:  Anaesthesist       Date:  2006-04       Impact factor: 1.041

9.  Patterns and clinical outcomes associated with routine intravenous sodium and fluid administration after colorectal resection.

Authors:  Andrew L Tambyraja; Fergus Sengupta; Alasdair B MacGregor; David C C Bartolo; Kenneth C H Fearon
Journal:  World J Surg       Date:  2004-09-29       Impact factor: 3.352

Review 10.  Salt of the earth or a drop in the ocean? A pathophysiological approach to fluid resuscitation.

Authors:  P Gosling
Journal:  Emerg Med J       Date:  2003-07       Impact factor: 2.740

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