Hypodermoclysis to treat dehydration: a review of the evidence

Dehydration is a serious acute condition in older adults associated with significant morbidity and mortality. Hypodermoclysis (HDC; the infusion of fluids into the subcutaneous tissue) can provide an alternative to intravenous (i.v.) rehydration of older adults. This article reviews the relevant literature on the use of HDC to treat mild to moderate dehydration in older adults. A comprehensive search of the literature was conducted to identify research reports on the use of HDC to treat dehydration in older adults. Articles published in English during the previous 10 years were reviewed to reflect current standards of practice. One systematic review; two randomized, controlled trials; and six cohort studies were identified and appraised. Only one study was conducted in the United States; the remainder were conducted in Europe, Asia, and Canada. The evidence indicated that HDC is as effective as i.v. rehydration of older adults with mild to moderate dehydration. The literature cites advantages of HDC over i.v. hydration, including the same number of or fewer complications, cost savings, greater patient comfort, and less nursing time to start and maintain the infusion. It remains unclear from the literature why HDC is used infrequently in the United States.