This guideline covers the general principles for managing intravenous (IV) fluid therapy in hospital inpatients aged 16 and over with a range of conditions. It aims to help prescribers understand the optimal amount and composition of IV fluids to be administered and the best rate at which to give them, to improve fluid prescribing and outcomes among people in hospital. It does not cover pregnant women, and those with severe liver or renal disease, diabetes or burns.
In December 2016 a footnote was added to recommendations 1.4.1 and 1.4.4, the tables on ‘Consequences of fluid mismanagement to be reported as critical incidents’ and ‘IV fluid prescription (by body weight) for routine maintenance over a 24 hour period’ and the accompanying algorithms giving more information on weight-based potassium prescriptions.
This guideline includes recommendations on:
- principles and protocols for IV fluid therapy
- assessment and monitoring of the person’s likely fluid and electrolyte needs
- IV fluid resuscitation
- IV fluids for routine maintenance alone
- training and education for all healthcare professionals involved in prescribing and delivering IV fluid therapy
Who is it for?
- Healthcare professionals
- People who receive IV fluid therapy in hospital and their families and carers
Guideline development process
This guideline was previously called intravenous fluid therapy in adults in hospital.
Next review: April 2017
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The application of the recommendations in this guideline is not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.