Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-22T23:24:04.999Z Has data issue: false hasContentIssue false
  • English
  • Français

Subcutaneous hydration by hypodermoclysis

Part of: Bespoke shallow archive Weizmann

Published online by Cambridge University Press:  06 April 2010

Jorge H. Lopez  and
Carlos A. Reyes-Ortiz
Jorge H. Lopez
Affiliation:
Universidad Nacional, Bogota, Colombia
Carlos A. Reyes-Ortiz*
Affiliation:
University of North Texas Health Science Center, Fort Worth, Texas, USA
*
Address for correspondence: Carlos A. Reyes-Ortiz, Department of Social & Behavioral Sciences, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard (EAD-711B), Fort Worth, Texas, 76107–2699, USA. Email: Carlos.ReyesOrtiz@unthsc.edu
Get access Rights & Permissions [Opens in a new window]

Summary

Subcutaneous hydration, or hypodermoclysis (HDC), is a very simple technique that should be practised more often by doctors and nurses who care for older patients. It involves less discomfort, generates less cost and has fewer adverse effects than the intravenous route and may reduce the need for admission to the emergency department. The main indication is the management of mild to moderate dehydration, and prevention of dehydration in patients who are intolerant of oral intake. It should not be administered in situations of severe dehydration, in emergency situations, or in patients with fluid overload. Isotonic or hypotonic solutions must be used with appropriate electrolytes. Certain medicines can be given simultaneously by HDC and this may be especially valuable in palliative care settings. In most cases there is no need to add hyaluronidase.

Keywords

subcutaneous hydrationhypodermoclysisolder personageingfluids
Type
Clinical geriatrics
Information
Reviews in Clinical Gerontology , Volume 20 , Issue 2 , May 2010 , pp. 105 - 113
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Schen, RJ, Singer-Edelstein, M.Subcutaneous infusions in the elderly. J Am Geriatr Soc 1981; 29: 583–85.CrossRefGoogle ScholarPubMed
2Schen, R.Letter: Response to: Hypodermoclysis – a victim of historical prejudice. Age Ageing 2005; 34: 656–57.CrossRefGoogle ScholarPubMed
3Miller, M. Disorders of fluid balance. In Halter, JB, Ouslander, JG, Tinetti, M, Studenski, S (eds), Hazzard's Geriatric Medicine and Gerontology, 6th edn.New York: McGraw Hill Medical, 2009, pp. 1047–48.Google Scholar
4Harchelroad, F.Acute thermoregulatory disorders. Clin Geriatr Med 1993; 9: 621–39.CrossRefGoogle ScholarPubMed
5Dardaine-Giraud, V, Lamande, M, Constans, T.Hypodermoclysis: benefits and indications in geriatrics. Rev Med Intern 2005; 26: 643–50.CrossRefGoogle ScholarPubMed
6Worobec, G, Brown, MK. Hypodermoclysis therapy in a chronic care hospital setting. J Gerontol Nurs 1997; 6: 23–28.Google Scholar
7Dall'Olio, G.Epidemia di colera asiatico del 1886 a Venezia. Esperienze di cura con l'ipodermoclisi. RIMeL IJLaM 2009; 5: 227–32.Google Scholar
8Daland, J.The treatment of cholera by hypodermoclysis and enteroclysis. Trans Am Climatolog Clin Assoc 1895; 10: 92–104.Google ScholarPubMed
9Evans, G.Illustrative cases. Myelogenous leukaemia – preliminary report. Cal State J Med 1904; 2: 242–44.Google ScholarPubMed
10Bartlett, W.Painless hypodermoclysis. Ann Surg 1921; 73: 161–64.CrossRefGoogle ScholarPubMed
11Israels, S, Wylie, K.The dangerous hypodermoclysis in infancy. Can Med Assoc J 1959; 80: 31–32.Google ScholarPubMed
12Gill, S, Dasgupta, M, Rochon, P.Hypodermoclysis in the treatment of dehydration. Am Fam Physician 2001; 64: 1516.Google ScholarPubMed
13Schen, R.Letter: Subcutaneous infusions in the elderly. BMJ 1981; 282: 823–24.CrossRefGoogle ScholarPubMed
14Berger, EY. Nutrition by hypodermoclysis. J Am Geriatr Soc 1984; 32: 199–203.CrossRefGoogle ScholarPubMed
15Abdulla, A, Keast, J.Hypodermoclysis as a means of rehydration. Nurs Times 1997; 93: 54–55.Google ScholarPubMed
16Olde Rikkert, MG, Bogaers, MA, Bruijns, E.Hypodermoclysis, an undervalued rehydration method in geriatrics. Tijdschr Gerontol Geriatr 1994; 5: 197–204.Google Scholar
17Dardaine, V, Ferry, M, Constans, T.Subcutaneous perfusion of hypodermoclysis: a useful rehydration method in geriatrics. Presse Med 1999; 28: 2246–50.Google ScholarPubMed
18Hypodermoclysis Working Group. Hypodermoclysis: Guidelines on the technique. Wrexham: CP Pharmaceuticals, 1998.Google Scholar
19Barua, P, Bhowmick, B.Hypodermoclysis – a victim of historical prejudice. Age Ageing 2005; 34: 215–17.CrossRefGoogle ScholarPubMed
20Berger, EY. Nutrition by hypodermoclysis. J Am Geriatr Soc 1984; 32: 199–203.CrossRefGoogle ScholarPubMed
21Barton, A, Fuller, R, Dudley, N.Using subcutaneous fluids to rehydrate older people: current practices and future challenges. Q J Med 2004; 97: 765–68.CrossRefGoogle ScholarPubMed
22Slesak, G, Schnurle, JW, Kinzel, E, Jakob, J, Dietz, K.Comparison of subcutaneous and intravenous rehydration in geriatric patients: a randomized trial. J Am Geriatr Soc 2003; 51: 155–60.CrossRefGoogle ScholarPubMed
23Lybarger, EH. Hypodermoclysis in the home and long-term care settings. J Infus Nurs 2009; 32: 40–44.CrossRefGoogle ScholarPubMed
24Walsh, G.Hypodermoclysis: an alternate method for rehydration in long-term care. J Infus Nurs 2005; 28: 123–29.CrossRefGoogle ScholarPubMed
25Fonzo-Christe, C, Vukasovic, C, Wasilewski-Rasca, AF, Bonnabry, P.Subcutaneous administration of drugs in the elderly: survey of practice and systematic literature review. Palliat Med 2005; 19: 208–19.CrossRefGoogle ScholarPubMed
26Arinzon, Z, Feldman, J, Fidelman, Z, Gepstein, R, Berner, YN. Hypodermoclysis (subcutaneous infusion) effective mode of treatment of dehydration in long-term care patients. Arch Gerontol Geriatr 2004; 38: 167–73.CrossRefGoogle ScholarPubMed
27Cerchietti, L, Navigante, A, Sauri, A, Palazzo, F.Hypodermoclysis for control of dehydration in terminal-stage cancer. Int J Palliat Nurs 2000; 6: 370–74.CrossRefGoogle ScholarPubMed
28Mancini, I, Body, JJ. Hypodermoclysis, a neglected approach. Rev Med Brux 1998; 4: A327–31.Google Scholar
29Bruera, E, Legris, MA, Kuehn, N, Miller, MJ. Hypodermoclysis for the administration of fluids and narcotic analgesics in patients with advanced cancer. J Pain Symptom Manag 1990; 5: 218–20.CrossRefGoogle ScholarPubMed
30Yap, LK, Tan, SH, Koo, WH. Hypodermoclysis or subcutaneous infusion revisited. Singapore Med J 2001; 42: 526–29.Google ScholarPubMed
31Schen, RJ, Edelstein-Singer, M.Hypodermoclysis in the home. J Am Geriatr Soc 1984; 32: 944.CrossRefGoogle ScholarPubMed
32Jones, D, McGeorge, S.Subcutaneous infusion. Nurs Older People 2007; 19: 18.CrossRefGoogle ScholarPubMed
33Moriarty, D, Hudson, E.Hypodermoclysis for rehydration in the community. Br J Community Nurs 2001; 6: 437–43.CrossRefGoogle ScholarPubMed
34Rochon, PA, Gill, SS, Litner, J, Fischbach, M, Goodison, AJ, Gordon, M.A systematic review of the evidence for hypodermoclysis to treat dehydration in older people. J Gerontol A Biol Sci Med Sci 1997; 52: M169–76.CrossRefGoogle ScholarPubMed
35Turner, T, Cassano, AM. Subcutaneous dextrose for rehydration of elderly patients – an evidence-based review. BMC Geriatrics 2004; 4: 2.CrossRefGoogle ScholarPubMed
36Sasson, M, Shvartzman, P.Hypodermoclysis: an alternative infusion technique. Am Fam Physician 2001; 64: 1575–78.Google ScholarPubMed
37Hays, H.Hypodermoclysis and system management. Can Fam Physician 1993; 39: 245.Google ScholarPubMed
38Schen, R, Arieli, S.Administration of potassium by subcutaneous infusion in elderly patients. BMJ 1982; 285: 1167–68.CrossRefGoogle Scholar
39Bruera, E, Brenneis, C, Michaud, M et al. Use of subcutaneous route for the administration of narcotics in patients with cancer pain. Cancer 1988; 62: 407–11.3.0.CO;2-T>CrossRefGoogle ScholarPubMed
40Woodall, H.Alternatives to rehydration during hypodermoclysis. Am Fam Physician 2002; 66: 28.Google ScholarPubMed
41Frisoli Junior, A, de Paula, AP, Feldman, D, Nasri, F.Subcutaneous hydration by hypodermoclysis. A practical and low cost treatment for elderly patients. Drugs Aging 2000; 16: 313–19.CrossRefGoogle ScholarPubMed
42Desmidt, T, Constans, T.Subcutaneous infusion of esomeprazole in elderly patients in palliative care: a report of two cases. J Am Geriatr Soc 2009; 57: 1724–25.CrossRefGoogle ScholarPubMed
43Champoux, N, Du Souich, P, Ravaoarinoro, M, Phaneuf, D, Latour, J, Cusson, JR. Single-dose pharmacokinetics of ampicillin and tobramycin administered by hypodermoclysis in young and older healthy volunteers. Br J Clin Pharmacol 1996; 42: 325–31.CrossRefGoogle Scholar
44Woodall, HE. Alternatives to rehydration during hypodermoclysis. Am Fam Physician 2002; 66: 28; author reply (Sasson M & Shvartsman P) 28, 30.Google ScholarPubMed
45Remington, R, Hultman, T.Hypodermoclysis to treat dehydration: a review of the evidence. J Am Geriatr Soc 2007; 55: 2051–55.CrossRefGoogle ScholarPubMed
46Molloy, W, Cunje, A.Hypodermoclysis in the care of older adults: an old solution for new problems? Can Fam Physician 1992; 38: 2038–43.Google ScholarPubMed
47Dutertre, JP, Constans, T.L-hypodermoclyse: une technique oubliee. Rev Med Intern 1991; 12: 153–55.CrossRefGoogle Scholar
48Jain, S, Mansfield, B, Wilcox, MH. Subcutaneous fluid administration – better than the intravenous approach? J Hosp Infect 1999; 41: 269–72.CrossRefGoogle Scholar
49O'Keeffe, ST, Geoghegan, M.Subcutaneous hydration in the elderly. Ir Med J 2000; 93: 197–98.Google ScholarPubMed
50Schen, RJ, Singer-Edelstein, M.Hypodermoclysis. JAMA 1983; 250: 1694–95.CrossRefGoogle ScholarPubMed
51Challiner, YC, Jarrett, D, Hayward, MJ, Al-Jubouril, MA, Julious, SA. A comparison of intravenous and subcutaneous hydration in elderly acute stroke patients. Postgrad Med J 1994; 70: 195–97.CrossRefGoogle ScholarPubMed
52Mongardon, N, Le Manach, Y, Lescot, T, Langeron, O, Tresallet, C.Subcutaneous hydration: a potentially hazardous route. Eur J Anesthesiol 2008; 25: 771–72.CrossRefGoogle ScholarPubMed
53O'Hanlon, S, Sheahan, P, McEneaney, R.Severe haemorrhage from a hypodermoclysis site. Am J Hosp Palliat Care 2009; 26: 135–36.CrossRefGoogle ScholarPubMed
54Gluck, SM. Hypodermoclysis revisited. JAMA 1982; 248: 1310–11.CrossRefGoogle ScholarPubMed
55Young, J. Administration of subcutaneous fluids (Hypodermoclysis). Bolton NHS Primary Care Trust. May 2007; 2: 1–9; available at: http://www.bolton.nhs.uk/Library/policies/NursDA011.PDF (accessed 15 December 2009).Google Scholar