SUBCUTANEOUS FLUIDS IN ELDERLY HOSPITAL PATIENTS WITH COGNITIVE IMPAIRMENT

Sixty patients (mean age 80 years) with cognitive impairment who requi red parenteral fluids for at least 48 h were randomized to receive eit her intravenous (i.v.) or subcutaneous (s.c.) fluids. There was no sig nificant difference in the mean volume of fluid prescribed over 48 h i n the two groups (s.c. 3.3 litres vs. i.v, 3.6 litres) or in the propo rtion of prescribed fluids actually administered (s.c. 0.82 vs. i.v. 0 .76). After adjusting for baseline differences, there was no differenc e between serum urea or creatinine levels in the two groups at 48 h. A gitation related to the infusion was reported in 11 (37%) patients rec eiving s.c. fluids and 24 (80%) patients receiving i.v. fluids Ip < 0. 005). The cost of the cannulae used during the study was pound 6.80 fo r the s.c. group and pound 28.70 for the i.v. group. Local oedema was noted in 2 patients in the s.c. group and led to re-siting of the infu sion in 1 patient. No other complication was noted. These results sugg est that s.c. fluid therapy is the treatment of choice in nonurgent si tuations for confused patients who require parenteral fluids.