What’s in the IV bag? Studies show safer option than saline

FILE - In this Sept. 5, 2013 file photo, chemotherapy is administered to a cancer patient via intravenous drip in Durham, N.C. IVs are one of the most common things in health care. Each year, tens of millions of people get one to prevent dehydration,

You’ve probably read about the new teen sexting research review published yesterday in JAMA Pediatrics: about one in four teens have received a “sext,” a text message with sexual content, and approximately one in seven have sent one. The findings are solid and come from a review of more than three dozen studies. But most outlets reporting on the study—and apparent alarm about it—have not dug deeply into the challenges of studying texting, what we still don’t know (a LOT) and why we should take a deep breath before freaking out about the findings.

What did the study find?

The researchers found 15% of teens have sent a sext, and 27% have received one. Unsurprisingly, the older teens were, the more likely they were to send or receive a sext. Also, the frequency of sexting among teens has been increasing over the past decade — again unsurprising since ownership and use of cell phones has also increased among adolescents. (Most of the sexting happened over cell phones, though some involved computers too.)

Potentially more concerning numbers are that 12% of teens said they’ve forwarded a sext without the permission of the person they received it from, and 8% of teens had one of their sexts forwarded without giving their consent.

How was the study done?

The researchers analyzed the findings of 39 studies involving 110,380 adolescents ranging from 12-17 years old. The studies had been published between 2009 and 2016 and most (34) measured how many teens have sent sexts. Another 20 measured receiving them, five looked at forwarding them without consent, and four examined having a sext forwarded without consent.

What are the risks of sexting?

According to a tip sheet for parents in the same journal, “Risks include emotional distress for those who are pressured to send these photos as well as those who receive these photos. Sexting can also cause harm if photos are distributed widely, causing increased distress or embarrassment.”

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The tip sheet also notes that sexting can lead to legal repercussions, but few courts prosecute these anymore, particularly since the possibility of a lifetime label of sex offender — potentially for sending a half-nude photo of yourself just once to your boyfriend or girlfriend — can destroy a person’s life.

Why do teens sext?

If this is a serious question, you’ve never met a teenager and appear to have forgotten your entire adolescence. But if that’s the case, here’s what the experts have to say in their tip sheet for parents in JAMA Pediatrics: “Adolescence is a time of life in which teenagers are learning about their own bodies, how to take risks, and about romantic attractions. For some teenagers, engaging in sexting may feel like a way to explore their attraction to someone.”

What should parents do about it?

Talk to your kids, but be sensible, keep some perspective and consider the actual risks of different circumstances. For example, consider this statement from the study: “A higher rate among older youth is expected and generally corresponds to the age of sexual identity and exploration, which lends credence to the notion that youth sexting may be an emerging, and potentially normal, component of sexual behavior and development.” See how much we still don’t know below.

What data are we missing most?

We know almost nothing about tween sexting. The only study that looked at sexting in those under age 12 was done in 2010-2011, which might as well be a century ago in the digital age. How common sexting is in this age group is particularly important: “Relationships among tweens are often transient, which may make them more vulnerable to having sexts forwarded without consent,” the authors wrote. “Moreover, given their relative cognitive naïveté, tweens may be particularly vulnerable to sextortion (ie, nude images and/or videos are used as a form of threat or blackmail) and, like youth who report early sexual debut, may be at risk for a host of risky behaviors and negative consequences.”

But here’s the thing: Sexting is REALLY hard to study—too hard to draw broad conclusions yet.

New research calls into question what’s in those IV bags that nearly every hospitalized patient gets. Using a different intravenous fluid instead of the usual saline greatly reduced the risk of death or kidney damage, two large studies found.

The difference could mean 50,000 to 70,000 fewer deaths and 100,000 fewer cases of kidney failure each year in the U.S., researchers estimate. Some doctors are hoping the results will persuade more hospitals to switch.

“We’ve been sounding the alarm for 20 years” about possible harms from saline, said Dr. John Kellum, a critical care specialist at the University of Pittsburgh. “It’s purely inertia” that prevents a change, he said.

Kellum had no role in the studies, which were discussed Tuesday at a critical care conference in San Antonio and published by the New England Journal of Medicine. Federal grants helped pay for the work.

IVs are one of the most common things in health care. They are used to prevent dehydration, maintain blood pressure or give patients medicines or nutrients if they can’t eat.

Saline — salt dissolved in water — has been the most widely used fluid in the U.S. for more than a century even as evidence has emerged that it can harm kidneys, especially when used a lot.

Other IV solutions called balanced fluids include saline but also contain potassium and other things that make them more like plasma, the clear part of blood. They’re widely used in Europe and Australia.

The studies involved 28,000 patients at Vanderbilt University who were given IVs of saline or a balanced fluid. For every 100 people on balanced fluids, there was one fewer death or severe kidney problem.

Since there are about 30 million people hospitalized in the U.S. alone each year, “there are tens or hundreds of thousands of patients who would be spared death or severe kidney problems by using balanced fluids instead of saline,” said one study leader, Vanderbilt’s Dr. Matthew Semler.

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