Adverse effects of subcutaneous vs intravenous hydration in older adults: An assessor-blinded randomised controlled trial (RCT)

Abstract

Background Hydration therapy is essential in the care of the older patient. Subcutaneous (SC) hydration is a relevant method for parenteral hydration, but clinical trials on the subject have methodological shortcomings compared to updated standards. Design Assessor-blinded, non-inferiority RCT to explore if SC is a safe alternative to intravenous (IV) hydration. Participants Eligible patients were: Admitted patients 65 years or older with a need for parenteral hydration. The targeted sample size was 67 patients in each group. Intervention Patients were randomised to parenteral hydration via an IV or SC catheter during a 24 hours observation period. The non-randomised catheter (inactive) was placed as a sham on the patient, thereby blinding the caregivers and outcome assessors. Measurement Our primary outcome was the proportion of patients reporting at least one adverse effect with a non-inferiority calculation using a 20% margin. Results We included 51 patients, with 24 randomised to SC and 27 to IV. We were unable to reach our target sample size due to challenges in recruitment, time limitation, and COVID-19. For the outcome of adverse effects, SC was non-inferior to IV (p = 0.012). Time spent on inserting the catheters was shorter with SC (p = 0.001). The groups did not differ by pain of insertion, discomfort during infusion, or the risk of developing delirium. Conclusion SC is a safe alternative to IV hydration, is faster to place and should be an available method for parenteral hydration wherever older adults are cared for. Trial registration ClinicalTrials.gov Identifier: NCT03710408

Eficácia da hipodermóclise no cuidado paliativo em enfermarias de clínica geral

“…(2021) 13 Foram incluídos 51 pacientes. Destes, 14 foram recrutados em unidade de avaliação aguda, 32 na enfermaria ortopédica e 5 em unidade de cuidados de curto prazo.…”

Problematization methodology’s impact on nursing and medical students’ knowledge about hypodermoclysis: quasi-experimental study

“…Among the hypodermoclysis advantages are its low cost, low risk of complications and adverse events, and its easy insertion and maintenance (1,(4)(5) . Another considerable advantage is that its use prevents the patient from being subjected to several punctures, as happens in the intravenous route (6) .…”

Impacto da metodologia de problematização no conhecimento de estudantes de enfermagem e medicina sobre hipodermóclise: estudo quase experimental

“…Entre as vantagens da hipodermóclise estão seu baixo custo, baixo risco de complicações e eventos adversos e sua fácil inserção e manutenção (1,(4)(5) .…”