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Do IV fluids resuscitate patients with uncomplicated acute alcohol intoxication by hastening ethanol clearance?

Three Part Question

Do [patients with uncomplicated acute alcohol intoxication], have increased ethanol clearance with the administration of [Intravenous fluids] compared with [no intervention at all]?

Clinical Scenario

A young man has been drinking all night with his friends and staggers home. He is found snoring on the pavement and is brought to hospital by ambulance. Clinical examination is unremarkable and there is no evidence of trauma or other injuries. His blood tests are normal. He smells heavily of alcohol and is not fit for discharge. Would IV fluid therapy increase ethanol clearance facilitating his discharge?

Search Strategy

Ovid interface search:
Medline 1966-05/2003
({exp fluid therapy AND ethanol/or alcohol intoxication/or alcoholism/or alcohol drinking LIMIT to human and English})

Search Outcome

41 articles found, of which only three were relevant.

Relevant Paper(s)

Author, date and country Patient group Study type (level of evidence) Outcomes Key results Study Weaknesses
Troups et al
1992
USA
19 volunteers (14 males and 5 females)ObservationalEthanol clearanceNo significant differences or predictable trendsNo control group. Small sample size. Time when 2nd post hydration blood ethanol level taken, not identified.
Gershmann
1991
USA
103 patients.41 received IV fluidsObservationalEthanol clearanceNo change in clearance rate as a result of IV fluidsHeterogenous group of patients. No distinction between chronic alcoholics and normal individuals
Li et al
1999
USA
10 volunteers ( 5 males and 5 females)Crossoverethanol clearanceIV fluids do not accelerate ethanol clearanceSmall sample size

Clinical Bottom Line

There is no good evidence to support the use of IV fluids in resuscitation of patients with uncomplicated acute alcohol intoxication

References

  1. Troups VJ, Pollack CV, carlton FB Letters to the editor Journal of emergency medicine 1992;10:491-492
  2. Gershmann H, Steeper J. Rate of clearance of ethanol from the blood of intoxicated patients in the emergency department and letters to the editor Journal of emergency medicine 1991;9:307-311/ 1992;10:492-493
  3. Li J, Mills T, erato R IV saline has no effect on blood ethanol clearance Journal of emergency medicine 1999;1:1-5