Oral or IV fluids for Heat Exhaustion Patients?

Heat exhaustion can result from inadequate fluid intake, leading to dehydration and increased core temperatures (Hubbard et al., 1984). The choice between oral or intravenous (IV) fluids for treating heat exhaustion depends on the individual's hydration and perfusion status (Macintire, 2008). Studies have shown that a combination of IV and oral fluid replacement after exercise-induced dehydration can reduce heat-related symptoms more effectively than a single mode of rehydration (McDermott et al., 2013). Additionally, research indicates that both IV and oral rehydration are equally effective in treating dehydration after exercise-induced dehydration (Castellani et al., 1997).

In the medical field, the administration of fluids, whether orally or intravenously, is crucial in various conditions. For example, in the prevention of contrast-induced nephropathy, studies have emphasized the significance of hydration through oral or IV fluid administration (Zaki et al., 2022). Moreover, in cases of hypotension following certain medical procedures, such as carotid artery stenting, oral medications like midodrine have been found effective when IV fluids and inotropes were not successful (Jenab et al., 2022).

Regarding fluid management, particularly in emergency settings, studies have explored different fluid administration strategies. Research on patients with suspected infections in the emergency department has compared oral and IV fluid administration over a 24-hour period (Jessen et al., 2021). Similarly, in patients with sepsis, there is an ongoing debate regarding the optimal fluid volume strategy, with some data favoring restrictive fluid administration (Jessen et al., 2022).

The choice between oral and IV fluids for heat exhaustion patients should be based on individual assessment, considering the severity of dehydration and the presence of other medical conditions that may impact fluid absorption and utilization. Both oral and IV fluid administration have their places in medical practice, and the decision should be tailored to the specific needs of the patient.

References:

  • Castellani, J., Maresh, C., Armstrong, L., Kenefick, R., Riebe, D., Echegaray, M., … & Castracane, V. (1997). Intravenous vs. oral rehydration: effects on subsequent exercise-heat stress. Journal of Applied Physiology, 82(3), 799-806.
    https://doi.org/10.1152/jappl.1997.82.3.799
  • Hubbard, R., Sandick, B., Matthew, W., Francesconi, R., Sampson, J., Durkot, M., … & Engell, D. (1984). Voluntary dehydration and alliesthesia for water. Journal of Applied Physiology, 57(3), 868-873.
    https://doi.org/10.1152/jappl.1984.57.3.868
  • Jenab, Y., Hosseini, K., & Abtahi-Eivary, S. (2022). Treatment via oral midodrine in a patient with prolonged hypotension following carotid artery stenting: a case report. Journal of Medical Case Reports, 16(1).
    https://doi.org/10.1186/s13256-022-03270-5
  • Jessen, M., Andersen, L., Thomsen, M., Jensen, M., Kirk, M., Kildegaard, S., … & Kirkegaard, H. (2021). Twenty‐four‐hour fluid administration in emergency department patients with suspected infection: a multicenter, prospective, observational study. Acta Anaesthesiologica Scandinavica, 65(8), 1122-1142.
    https://doi.org/10.1111/aas.13848
  • Jessen, M., Andersen, L., Thomsen, M., Kristensen, P., Hayeri, W., Hassel, R., … & Kirkegaard, H. (2022). Restrictive fluid administration vs. standard of care in emergency department sepsis patients (refaced sepsis)—protocol for a multicenter, randomized, clinical, proof-of-concept trial. Pilot and Feasibility Studies, 8(1).
    https://doi.org/10.1186/s40814-022-01034-y
  • Macintire, D. (2008). Pediatric fluid therapy. Veterinary Clinics of North America Small Animal Practice, 38(3), 621-627.
    https://doi.org/10.1016/j.cvsm.2008.01.004
  • McDermott, B., Casa, D., Lee, E., Yamamoto, L., Beasley, K., Emmanuel, H., … & Maresh, C. (2013). Thermoregulation and stress hormone recovery after exercise dehydration: comparison of rehydration methods. Journal of Athletic Training, 48(6), 725-733.
    https://doi.org/10.4085/1062-6050-48.6.01
  • Zaki, H., Bashir, K., Iftikhar, H., Alhatemi, M., & Elmoheen, A. (2022). Evaluating the effectiveness of pretreatment with intravenous fluid in reducing the risk of developing contrast-induced nephropathy: a systematic review and meta-analysis. Cureus.
    https://doi.org/10.7759/cureus.24825


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