IV Fluids for Dehydration

Dehydration impacts 20%-30% of older adults (1). Mild dehydration can typically be resolved without invasive treatment.  

However more severe cases may require intravenous (IV) fluids.  IV hydration is a common treatment during acute medical care, especially in hospitalized patients (2). 

IV fluids for dehydration do not come without risks however. This article will explain basics of IV hydration including uses and risk vs. benefits. 

What is Dehydration?

Dehydration is the harmful decline of fluids in the body without adequate replacement. Learn more about dehydration in the elderly here. 

What is IV Hydration

IV fluids are hydration provided through a vein, bypassing the gastrointestinal tract. Most commonly they are a saline solution that may contain dextrose (sugar) and/or electrolytes. 

They provide minimal, if any, calories. Administration typically would occur at the hospital, nursing home, or possibly doctor’s office. 

Resuscitation Fluids

Resuscitation fluids are IV fluids to replace the fluid lost from volume depletion, such as from blood loss (3). 

Maintenance Fluids

Maintenance IV fluids are usually used when drinking enough fluids for a prolonged period of time is not possible (4). 

Reasons for IV Fluids

IV hydration may be used in a variety of situations (5)

• Dehydration 
• Hypotension: low blood pressure
• Decreased cardiac output
• Impaired tissue perfusion
• Low urine output
• Tachycardia: fast heart rate 
• Blood loss
• Increased loss of bodily fluids
  • Vomiting
  • Diarrhea
  • Wound drainage  
• Infection
• Burns
• Surgery
• Electrolyte abnormalities
• Prolonged inability to drink

Risks of IV Fluids

Even though IV fluids can correct dehydration, they are not without risks. Potential complications associated with IV hydration include (6) (7) (8) (9):

• Cellulitis: bacterial skin infection
• Edema: swelling 
• Phlebitis: vein inflammation 
• Erythema: skin redness
• Vein collapse 
• Infiltration: fluid goes outside the veins causing bruising and stinging 
• Hyponatremia: low sodium
• Pain
• Kidney dysfunction
• Fluid overload
• Organ damage or failure 
• High financial cost 
• Nutrient imbalance from electrolyte over correction 

IV Fluids for Dehydration 

The geriatric population is at increased risk for dehydration. This is frequently related to inadequate fluid intake, however can occur for other reasons. 

While IV hydration can ensure fluid needs are being met, they are not a long term solution. This is due to their associated risks and the bypassing of the gastrointestinal tract. 

When dehydration is related to an acute and temporary condition then IV fluids can assist in recovery. They are an effective way to correct electrolyte imbalances. 

However, when dehydration occurs from chronic, progressive diseases such as dementia, they are really only a bandaid on a long term issue that is unlikely to improve.  

This is when advanced directives are of utmost importance. Living wills can indicate whether life prolonging measures, including artificial nutrition and hydration, are desired or not.

If someone does not have a living will, then it is up to the responsible party to decide if IV fluids would be desired during an end stage or terminal disease. 

Practical Takeaways

IV fluids can treat acute dehydration in the elderly, but are not without risks.

Discuss wishes for life prolonging measures, including artificial nutrition and hydration, with loved ones.