Abstract Rationale After Hurricane Helene in Fall 2024, a nationwide shortage of intravenous (IV) fluids prompted rapid changes in perioperative fluid management. Advocate Aurora Health responded by implementing IV fluid–conserving protocols across elective procedures, including outpatient bronchoscopies. Since intravascular volume affects hemodynamic stability and oxygen delivery, it was critical to assess the clinical impact of these measures. This study aimed to evaluate whether fluid conservation influenced post-procedural oxygenation and cardiovascular outcomes, offering evidence to guide care during resource-limited conditions. Methods We conducted a retrospective cohort study of 400 patients undergoing outpatient bronchoscopy at multiple Aurora BayCare sites. Two groups were analyzed: 200 patients treated before and 200 after the implementation of fluid-conserving protocols. To reduce variability, patients undergoing bronchoscopic lung volume reduction or central airway obstruction procedures were excluded. Data from electronic medical records included demographics, procedural details, IV fluid volumes, oxygen saturation, heart rate, mean arterial pressure (MAP), medication use, and post-procedure complications. Statistical comparisons used t-tests and chi-square tests, with significance set at p .05. A post hoc power analysis assessed the sensitivity of oxygenation findings. Results Baseline characteristics—age, BMI, procedure duration, and PACU recovery time—were similar between groups. Median IV fluid volumes were significantly lower post-intervention (275.7 ± 370.9 mL vs. 593.5 ± 433.3 mL; p .001). Oxygen saturation remained stable across all perioperative time points. However, the post-intervention group showed higher heart rates at multiple intervals and lower minimum MAP at T3. Maximum oxygen flow was also higher (p = .027), suggesting compensatory adjustments. Arrhythmias were significantly reduced (0.5% vs. 5.5%; p = .003), while bronchodilator (46.0% vs. 31.0%; p = .002) and antiarrhythmic use (22.0% vs. 0.5%; p .001) increased. No significant differences were found in hospital admissions, pneumothorax rates, or comorbidities such as COPD and CHF. Conclusions Fluid-conserving strategies during bronchoscopy did not compromise oxygenation or increase adverse events. Cardiovascular responses and medication use were affected, but overall patient safety was preserved. These findings highlight the resilience of procedural care under constrained conditions and support adaptive perioperative strategies. Future research should explore long-term recovery impacts and broader applicability across procedural domains. This abstract is funded by: Advocate Aurora Research Institute
Mendoza-Ayala et al. (Fri,) studied this question.