Subcutaneous Versus Intravenous Rehydration in Hospitalized Older Adults

Abstract

Subcutaneous rehydration is an optional infusion route in hospitalized older adults. This meta-analysis sought to compare the effectiveness of subcutaneous versus intravenous (IV) fluid administration to reverse mild-to-moderate dehydration in hospitalized older adults. A literature search was performed. No restrictions were imposed regarding language. Three randomized clinical trials conducted with patients 60 years of age or older treated with subcutaneous or IV rehydration were included, with a total sample size of 197 patients. Controlled quasi-randomized and crossover trials were excluded. The primary end point was reversal of dehydration. Secondary end points were patient satisfaction and frequency of adverse events (eg, cellulitis, edema, phlebitis, erythema, hyponatremia, and pain). Both treatments were effective in rehydrating the patients within 48 hours, with no statistically significant difference between the groups. Subcutaneous fluid administration effectively reversed dehydration while protecting against phlebitis. Since the quality of evidence was considerably low, further multicenter randomized clinical trials of efficient methodological quality should be conducted to consolidate the body of evidence.

Impacto da metodologia de problematização no conhecimento de estudantes de enfermagem e medicina sobre hipodermóclise: estudo quase experimental

“…Outra vantagem considerável é que seu uso evita que o paciente seja submetido a várias punções, como ocorre na via intravenosa (6) . Apesar de seus benefícios, há baixa adesão ao uso da hipodermóclise, bem como pouca divulgação de sua técnica, principalmente no meio acadêmico (7) , além da predominância do uso da via venosa sobre a via subcutânea para administração de medicamentos, mesmo em pacientes com indicação para a via subcutânea (7) .…”

Impacto de la metodología de problematización en el conocimiento de estudiantes de enfermería y medicina sobre hipodermoclisis: estudio cuasiexperimental

“…Otra ventaja considerable es que su uso evita que el paciente sea sometido a múltiples punciones, como ocurre con el uso de la vía intravenosa (6) .…”

International Consensus Recommendation Guidelines for Subcutaneous Infusions of Hydration and Medication in Adults

“…There is a need for alternative drug and fluid delivery routes in patients with difficult-to-access vasculature, for oral intolerance, preservation of venous health, or clinical situations where there has been an inadequate therapeutic response to oral therapy 8. An alternative path is the subcutaneous route, a safe, effective, acceptable, and efficient mode of delivery of infusion therapy 1,8–11. In subcutaneous infusions, fluid is absorbed from the subcutaneous tissue to the circulation via the forces of diffusion and perfusion 4.…”