Perioperative medicine & outcomes
Standard Intraoperative Fluid Practices During the 2024 Intravenous Fluid Shortage
Main finding · Intraoperative crystalloid administrationResult — go to the resultAdjusted eβ 0.25 95% CI 0.24–0.26Authors' conclusion
In this cohort study's natural experiment, grossly reduced intraoperative crystalloid fluid administration was associated with lower urine output, reduced urinary catheter use, and fewer hospital readmissions, without worse patient-centered outcomes.
Study context
- Population
- Adults undergoing surgery at 9 hospitals of a Bronx, New York network during the 2024 IV fluid shortage, September 2 to December 31, 2024
- Participants
- 38,976 adults
- Exposure
- During vs before implementation of a fluid reduction bundle
- Duringn = 26,950
- Beforen = 12,026reference
- Outcome
- Change in intraoperative crystalloid administration
Methodological detailsnatural experiment, multicentre (9 hospitals)
- Natural experiment
- Multicentre (9 hospitals)
Main finding
Intraoperative crystalloid administration
Adjusted eβ
0.25
95% CI 0.24–0.26
P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Further findings
Urine output
- Intervention associated with lower urine output
- adjusted eβ 0.91; 0.85-0.96; P = .002 (95% CI, P)
- Adjusted exponentiated β coefficient
Urinary catheter utilization
- Intervention associated with reduced urinary catheter utilization
- ARR 0.87; 0.83-0.92; P < .001 (95% CI, P)
- Adjusted relative risk
Hospital readmissions
- Intervention associated with fewer hospital readmissions
- ARR 0.82; 0.75-0.89; P < .001 (95% CI, P)
- Adjusted relative risk
Costs of care
- No meaningful difference in costs of care
- adjusted eβ 1.00; 0.98-1.01; P = .46 (95% CI, P)
- Adjusted exponentiated β coefficient
Safety
Intraoperative hypotension
- No meaningful difference in intraoperative hypotension
- adjusted eβ 1.01; 1.00-1.02; P = .07 (95% CI, P)
- Adjusted exponentiated β coefficient
Postoperative AKI
- No meaningful difference in postoperative AKI
- ARR 0.97; 0.86-1.09; P = .58 (95% CI, P)
- Adjusted relative risk
Original publication
Standard Intraoperative Fluid Practices During the 2024 Intravenous Fluid Shortage. JAMA Netw Open. Published 1 September 2026. doi:10.
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