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Hypodermoclysis
by: DR SOON

Most doctors would be surprised to read this. Hypodermoclysis means the administration of fluids into the subcutaneous tissue. Before the development of high quality plastic intravenous cannulae, the insertion of a steel needle into the subcutaneous tissue was a common method of administering fluids. I believe most doctors would be surprised to hear that there has been a resurgence of popularity of hypodermoclysis in recent years.

A fine bore needle is inserted in any convenient location, such as abdominal wall, chest or thigh. Insertion requires minimal skill. As the needle is not in the vein no thrombophlebitis occurs. The rate of flow is not critical since the fluid does not immediately enter the vascular compartment. Pulmonary oedema is therefore extremely unlikely. This technique is suitable for home use.

A convenient regime is to administer one litre of normal saline overnight, removing the set during the daytime so as to allow the patient to move around freely.  Drug additives may be considered. The addition of hyaluronidase 150-300 units in each litre of saline facilitates the subcutaneous spread of saline. Potassium chloride 40 mmol/L can be added to the infusion. The addition of morphine is not wise because of the lack of control over dosages. Dextrose 5% can be infused to provide carbohydrate, but this may cause discomfort in some patients.

There are divergent views about the need for rehydration in dying patients. A consensus is developing that if fluids are required the subcutaneous is usually most convenient and a volume of one litre a day is usually adequate.

If you have questions related to this article you may e-mail me at doctor@soontongkiong.com quoting the contents of the article.

About the author

DR SOON is a medical practitioner. He holds four degrees. MBBS (University of Malaya), MBA (University of East Asia), LLB (Hons) (University of Wolverhampton), Master of Medicine (Edith Cowan University

:

Dr SOON is the owner of AskMyVisitor.com and  MyScriptDoctor.com

where you can find the most up-to-date advice and information on

many medical, health and lifestyle topics.

 



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