Eliminating Intravenous Fluid During Colonoscopies Results in Statistically but Not Clinically Significant Hypotension

Eliminating Intravenous Fluid During Colonoscopies Results in Statistically but Not Clinically Significant Hypotension

Total Patients

Limitations

Gender

Potential Savings

Age

Episodes of Hypotension

Vasopressor Adminsitration

MAPs

The Data Breakdown

Gender Breakdown

Minimum MAP (mmHg) Charted

Mean arterial pressures were obtained through Epic documentation. All data was assumed to be valid unless it was manually removed by the provider.

Limitations

• The amount of IV fluid administered was assumed to be 1 L during the pre-shortage period (August) and 0 L during the shortage months (November–December), which may not accurately represent true patient-level fluid volumes and could introduce exposure misclassification.
• Vital sign data were extracted from the electronic health record and are limited by the accuracy and consistency of provider documentation.
• Patient comorbidities and baseline health status were not fully accounted for, which may influence hemodynamic responses and confound the observed associations.
• Only phenylephrine administration was analyzed; the use of other vasopressors (e.g., ephedrine, norepinephrine) was not evaluated and may have affected mean arterial pressure outcomes. Things may not be generalizable to other institutions or clinical settings.
• Patient follow-up was not conducted to patient outcomes such ass prolonged recovery or escalation in care coudl not be assessed.

Age Distribution

Total Patients

Potential Fiancial Savings

Current Costs:

• 1L Lactated Ringers $12.85
• IV Tubing Set $17.17
• Total Price = $30.02

The graph below estimates the potential savings if we eliminated IV fluids completely during colonoscopies and averaged 400 cases each month.

Use of Vasopressors

THE AUTHORS!

Melissa Rogers, BSN, RN, CCRN Yan Liu, BSN, RN, CCRN Jacque Bentley, BSN, RN, CCRN Megan Clancy, DNP, CRNA Sarah Given, DNP, ANP-BC Beth Israel Deconness Medical Center

Mean arterial pressures were obtained through Epic documentation. All data was assumed to be valid unless it was manually removed by the provider.

Hypotension

Hypotension is defined as a mean arterial pressure (MAP) less than 65 mmHg.