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
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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.