Hypodermoclysis versus intravenous hydration in palliative medicine: clinical effectiveness

Palliative care patients struggle to cope with many symptoms. Malnutrition and dehydration may develop either as a consequence of the disease itself or as a result of its treatment. Parenteral methods, such as the intravenous method, are advanced treatment options, but sometimes patients experience problems related to venous depletion. Although hypodermoclysis (HDC) has been known for a long time, it is often overlooked in clinical practice. The aim of this study was to analyse the clinical differences between the HDC method and the intravenous hydration method.

This prospective, randomised clinical trial was conducted with patients treated at a Palliative Care Centre. Thirty-one patients with symptoms of venous depletion constituted the study group, while 30 patients with no venous depletion constituted the control group. After training the nurses at the Centre on the HDC method, rehydration therapy was initiated in both groups, and patient characteristics, infusion indications, the application time for both methods, infusion duration and complications were examined and analysed.

Complications were observed at a rate of 12.9% in the study group, compared with 36.7% in the control group. The preparation time for the HDC in the study group was 2.13±0.56 min, while in the control group, it was 8.5±4.76 min. The cost in the study group was 114.93±0 Turkish Lira, while in the control group, it was 141.73±0.05 Turkish Lira.

The HDC method was found to be easier to perform by healthcare professionals, caused fewer complications and was less expensive than the intravenous fluid infusion method. Further prospective studies are needed.