Subcutaneous fluid infusion in a long-term care setting

OBJECTIVE: To study the use of hypodermoclysis in a long-term care setting for chronic fluid supplementation and to compare it to intravenous (IV) flu id in the treatment of acute mild to moderate dehydration. DESIGN: A prospective observational study. PARTICIPANTS: Fifty-five residents of a long-term care facility treated wit h fluid therapy during a 5-week period. MAIN OUTCOME MEASURES: Efficacy of hydration and adverse effects were obtai ned from detailed chart review, interviews with healthcare providers, and i nvestigators' observations. RESULTS: The study subjects were frail older people. Hypodermoclysis was us ed for maintenance fluid needs in 24 residents; none of these residents req uired any additional fluid therapy for dehydration. in addition, 37 residen ts received fluids for acute dehydration. In these residents, hypodermoclys is was associated with clinical improvement in 57% and no clinical change i n 25%. Recipients of IV fluids improved 81% of the time and the remainder w ere unchanged. Hypodermoclysis was associated with fewer fluid therapy-rela ted complications relative to IV therapy IP =.04). CONCLUSIONS: Hypodermoclysis is an effective procedure for providing fluids for both chronic maintenance needs and acute situations associated with mi ld to moderate dehydration in a long-term care setting. Hypodermoclysis app ears safer and can avoid transfers to hospital for rehydration.