Articles, Blog

Saline Is Based on Terrible Science, Why Do We Use It Every Day?

February 18, 2020


In my mind nothing is as synonymous with hospitals
as a bag of intravenous saline hanging from a little metal tree. They’re practically ubiquitous in emergency
rooms and it’s a serious problem when they’re in short supply. Normal Saline, as it’s called, is incredibly
simple, it’s mostly just sterile water and about point-nine percent good old fashioned
sodium chloride, aka table salt. When injected intravenously it’s used to
help deliver drugs or rehydrate patients. Doctors prescribe it to treat a variety of
symptoms. Headache? Saline. Vomiting? Saline. Lightheaded? Saline. It’s like Salt Bae became a doctor, just
sprinkling a little salt into everyone’s veins. But for something so vital to modern medicine,
it’s surprisingly under studied, and there may be something better out there. The practice of saline injection is rooted
in the 1830s, when cholera was booming worldwide and everyone was pooping themselves to death. Scottish doctor Thomas Latta started treating
the severe dehydration caused by fluid loss in the most direct way possible, by pumping
fluid right back into the bloodstream. Physicians back then didn’t know too much
about what was in blood but they knew it tasted salty. Which is a weird thing to know, but moving
on. So, Latta’s first intravenous solution had
a mix of salt and sodium bicarbonate, better known as baking soda. Apparently doctors back then just rummaged
through their kitchen for medicine. It’s ok though, Dr. Latta said the
first person he tried it on was practically dead anyway so NBD. The point-nine percent saline solution we
use today stems from an 1883 experiment by Dutch scientist Dr. Hamburger. I love that name. Dr. Hamburger concluded that was the concentration
of sodium and chloride in human blood and so an intravenous solution should have the
same levels to be normal. Hence the name, “normal saline.” Somehow, and no one’s quite sure how, Dr.
Hamburger’s results became the basis for IV fluids that we still use to this day. But Dr. Hamburger was wrong. His estimates were a little too high for sodium,
and much too high for chloride. Still it wasn’t until the 80s that scientists
started studying possible downsides, and found that normal saline caused kidney damage in
dogs and later that it could turn blood acidic. But there may be a better solution. See what I did there? Because solution can mean- forget it. A contemporary of Dr. Hamburger, Sidney Ringer,
concocted a fluid with levels of sodium, chloride, and potassium that are similar to blood’s. It’s called lactated Ringer’s solution,
and only in 2018, 135 years after Dr. Hamburger’s incorrect conclusion, were the two IV fluids
compared in a randomized trial. Researchers tested the two fluids on over
15,000 ICU patients, and the results aren’t mind-blowing at first glance. Patients who received a balanced solution
like lactated Ringer’s fared a tiny bit better, with one percent fewer either dying
or suffering kidney problems. One percent, big whoop right? Until you remember just how ubiquitous normal
saline is, how many millions of adults receive it each year. Considering lactated Ringer’s costs about
the same as normal saline, it looks like there’s no reason not to prescribe it instead, and
this is a helpful reminder to reexamine what we accept without second thought just because
it’s the way we’ve done things in the past. Are you thirsty for a new website, you should
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online and visit Domain.com. Put a little bit of salt water in your veins
and you’re fine, but put the wrong type of blood in and you’re in trouble. Why our our bodies compatible with some blood
types but not others? Check out this video of a little baby me to
learn more. One last thing, maybe you’ve figured this
out already, but you can actually make your own saline at home! But, y’know, don’t. Thanks for watching, don’t get too salty
because there’s always more videos here on Seeker.

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