Do IV fluids resuscitate patients with uncomplicated acute alcohol intoxication by hastening ethanol clearance?
Date First Published:
June 17, 2003
Last Updated:
June 17, 2003
Report by:
N.Dignon, T.Hassan, J.Vermeulen, SpR, SHO, SHO (Glasgow Royal Infirmary)
Search checked by:
T.Hassan, J. Vermeulen, Glasgow Royal Infirmary
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
Medline 1966-05/2003
Search Details:
({exp fluid therapy AND ethanol/or alcohol intoxication/or alcoholism/or alcohol drinking LIMIT to human and English})
Outcome:
41 articles found, of which only three were relevant.
Relevant Paper(s):
| Study Title | Patient Group | Study type (level of evidence) | Outcomes | Key results | Study Weaknesses |
|---|---|---|---|---|---|
| Letters to the editor Troups VJ, Pollack CV, carlton FB 1992 USA | 19 volunteers (14 males and 5 females) | Observational | Ethanol clearance | No significant differences or predictable trends | No control group. Small sample size. Time when 2nd post hydration blood ethanol level taken, not identified. |
| Rate of clearance of ethanol from the blood of intoxicated patients in the emergency department and letters to the editor Gershmann H, Steeper J. 1991 USA | 103 patients.41 received IV fluids | Observational | Ethanol clearance | No change in clearance rate as a result of IV fluids | Heterogenous group of patients. No distinction between chronic alcoholics and normal individuals |
| IV saline has no effect on blood ethanol clearance Li J, Mills T, erato R 1999 USA | 10 volunteers ( 5 males and 5 females) | Crossover | ethanol clearance | IV fluids do not accelerate ethanol clearance | Small sample size |
Bottom Line:
There is no good evidence to support the use of IV fluids in resuscitation of patients with uncomplicated acute alcohol intoxication
References:
- Troups VJ, Pollack CV, carlton FB. Letters to the editor
- Gershmann H, Steeper J.. Rate of clearance of ethanol from the blood of intoxicated patients in the emergency department and letters to the editor
- Li J, Mills T, erato R. IV saline has no effect on blood ethanol clearance