Intravenous Fluid Conservation in Endoscopic Procedures and Its Effects on the Outcomes of Patients Undergoing Nurse-Administered Moderate Sedation

BACKGROUND: After Hurricane Helene, which caused flooding and led to the shutdown of Baxter International, a major supplier of intravenous (IV) fluids, healthcare systems nationwide faced significant disruptions to their supply chains. In response, one health system implemented IV fluid conservation policies across its campuses to prioritize patients with critical needs. PURPOSE: This study evaluated the impact of withholding IV fluids during outpatient endoscopic procedures on patient blood pressure, heart rate, nausea, vomiting, and recovery time. METHODS: A retrospective chart review was conducted at an ambulatory gastroenterology center. Adults aged 18-85 who underwent specific endoscopic procedures with moderate sedation were included. RESULTS: Of the 1,535 cases reviewed, 56.9% occurred before IV fluid restrictions, and 96% of those received IV fluids. After the restriction, only 3.8% of patients received IV fluids. The lowest systolic and diastolic blood pressures, as well as the lowest heart rate, exhibited little variability between the pre- and post-restriction periods. Post-procedure recovery time was equal in both groups. CONCLUSIONS: Patients tolerated endoscopy and moderate sedation without significant hemodynamic changes during the IV fluid shortage. IMPLICATIONS: This clinic successfully adapted its practices during a critical supply shortage, maintaining safe and effective care despite limited access to IV fluids.