Halftime intravenous hyperhydration practices in sports games
Abstract:
Objective: To assess current pregame (PIVFH) and halftime intravenous fluid hyperhydration (HIVFH) practices, protocols, indications, complications, and perceived efficacy in National Collegiate Athletic Association Football Bowl Subdivision (NCAA-FBS) football players.
Design: Cross-sectional survey.
Setting: NCAA-FBS.
Participants: Head team physicians and athletic trainers from 71 unique NCAA-FBS Division 1 schools.
Interventions: Voluntary anonymous 28-question validated survey.
Main outcome measures: Number of teams using PIVFH and HIVFH.
Results: Intotal,: 73 (30.7%) institutions completed surveys, representing 71 of 238 (29.8%) unique NCAA-FBS institutions. Twenty eight of 71 (39.4%) of institutions reported using PIVFH, while 29 of 71 (40.8%) reported using HIVFH. For PIVFH (20/28, 71.4%) and HIVFH (18/21, 85.7%), most institutions reported 1 L of IV fluid was administered, typically normal saline. Most teams (20/29, 68.9%) reported that 1 to 3 players received HIVFH when the temperature was above 80°F, while 12 of 29 (41.4%) teams used HIVFH regardless of temperature. Complications related to IVFH were reported by 28 of 71 (39.4%) institutions. The most commonly cited complications were provider needlestick, pulmonary edema, and infection.
Conclusions: The use of PIVFH at NCAA-FBS institutions has remained relatively stable compared with prior studies. HIVFH, which was not previously reported, was used slightly more frequently than PIVFH and with greater variability based on ambient temperature. Many institutions reported complications related to IVFH, emphasizing the importance of carefully considering potential risks and benefits when implementing IVFH protocols.
Reference:
Schultz EA, Song L, Hwang CE. Pregame and Halftime Intravenous Hyperhydration Practices in National Collegiate Athletic Association Football Bowl Subdivision Teams. Clin J Sport Med. 2026 Jun 3. doi: 10.1097/JSM.0000000000001473. Epub ahead of print. PMID: 42234023.