Do IV fluids resuscitate patients with uncomplicated acute alcohol intoxication by hastening ethanol clearance?

Report By: N.Dignon, T.Hassan, J.Vermeulen - SpR, SHO, SHO
Search checked by T.Hassan, J. Vermeulen - SHO, SHO
Institution: Glasgow Royal Infirmary
Date Submitted: 17th June 2003
Last Modified: 17th June 2003
Status: Blue (submitted but not checked)

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
({exp fluid therapy AND ethanol/or alcohol intoxication/or alcoholism/or alcohol drinking LIMIT to human and English})

Search Outcome

41 articles found, of which only three were relevant.

Relevant Paper(s)

Author, date and country	Patient group	Study type (level of evidence)	Outcomes	Key results	Study Weaknesses
Troups et al 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.
Gershmann 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
Li et al 1999 USA	10 volunteers ( 5 males and 5 females)	Crossover	ethanol clearance	IV fluids do not accelerate ethanol clearance	Small sample size

Clinical 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 Journal of emergency medicine 1992;10:491-492
Gershmann H, Steeper J. Rate of clearance of ethanol from the blood of intoxicated patients in the emergency department and letters to the editor Journal of emergency medicine 1991;9:307-311/ 1992;10:492-493
Li J, Mills T, erato R IV saline has no effect on blood ethanol clearance Journal of emergency medicine 1999;1:1-5