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Dehydration and the dying patient

J E Ellershaw1, J M Sutcliffe, C M Saunders

  • 1St. Christopher's Hospice, London, England.

Journal of Pain and Symptom Management
|April 1, 1995
PubMed
Summary
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This study found no significant link between dehydration and symptoms like dry mouth or thirst in terminally ill cancer patients. Artificial fluid therapy may not effectively alleviate these common end-of-life symptoms.

Area of Science:

  • Palliative Care
  • Oncology
  • Clinical Hydration

Background:

  • Dehydration is common in terminally ill patients.
  • Anecdotal evidence suggests hydration alleviates symptoms like thirst and dry mouth.
  • The relationship between hydration status and symptoms in malignant disease requires investigation.

Purpose of the Study:

  • To investigate the relationship between dehydration and symptoms in patients with malignant disease.
  • To determine if artificial fluid therapy is effective in alleviating symptoms in dying patients.

Main Methods:

  • 82 subjects with malignant disease were studied during their dying phase.
  • Assessment included respiratory tract secretions, thirst, dry mouth, and serum biochemistry.
  • Follow-up data were collected post-mortem; patients died without artificial fluid therapy.

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Main Results:

  • No statistically significant relationship was found between hydration level and respiratory secretions.
  • Among patients able to respond, 87% had dry mouth and 83% felt thirsty.
  • No significant association between hydration level and these symptoms was observed.

Conclusions:

  • Artificial hydration may be futile in alleviating thirst and dry mouth in dying patients.
  • Further research is needed on the causes and treatment of these symptoms.
  • Findings challenge anecdotal evidence regarding hydration's symptomatic relief in end-of-life care.