Cost-effectiveness of recombinant human hyaluronidase-facilitated subcutaneous versus intravenous rehydration in children with mild to moderate dehydration

Subcutaneous hydration and medications infusions (effectiveness, safety, acceptability): A systematic review of systematic reviews

“…The study data reveal the following advantages of SC hydration over intravenous therapy: reduced catheter dislodgements, infection, and phlebitis (although more local reactions), clinical and biochemical improvements, less agitation related to the access device/infusion, increased patient/caregiver satisfaction, time and success in device placement, ease of use and number and cost of access devices and less staff time to start and maintain the infusion. A decision analytic model studying Spandorfer's pediatric study [45] supports these findings, finding the mean cost of hyaluronidase-facilitated subcutaneous hydration $167 USD, with cost savings attributed to ease of access where IV access is difficult and with shorter emergency department stay [68]. A pharmacoeconomic analysis also found SC therapy to be less costly than IV, for both hydration as well as administration of drugs (including immunoglobulin and opioid infusions) [69].…”

Hipodermóclise Como Tecnologia Integrativa Ao Processo Infusional Em Crianças

“…(5,19) Sobre a efetividade, os resultados apresentados sugerem que a HDC pode facilitar a infusão de fluidos em pacientes pediátricos em comparação com a via intravenosa, sendo apontada como uma prática alternativa ou mesmo integrativa ao processo de infusão de fluidos, visto a significância para o tempo de prescrição e início da infusão, menor número de tentativas necessárias para a punção em tecido subcutâneo, (18) o que reflete em menor estresse para criança, acompanhante e profissional, além do impacto positivo no tratamento e custos hospitalares. (8,20) Circunstâncias e fatos que permitem concluir que os profissionais e equipe de saúde, sobretudo a enfermagem, devem inserir a HDC na prática profissional.…”

Things We DON’T Do for No Reason

“…10,11 The success rate for peripheral IV placement ranged from 76% to 79%, whereas subcutaneous catheter placement was successful 90% to 100% of the time. [10][11][12] A mean cost comparison showed subcutaneous fluids with hyaluronidase cost $722 per patient versus $889 for IV fluids. The main difference in cost was due to shorter time in the ER and faster and easier placement of subcutaneous catheters.…”

“…The main difference in cost was due to shorter time in the ER and faster and easier placement of subcutaneous catheters. 12 Although subcutaneous rehydration is not ideal when there is a need for rapid fluid administration, a number of mildly to moderately dehydrated patients could be ideal candidates, with researchers of some studies suggesting 15% to 20% of children in an emergency department (ED) with moderate dehydration are unable to tolerate oral rehydration. 10,11 Despite this, many pediatric hospitalists are unfamiliar with hypodermoclysis, and it remains an infrequently used technique.…”