Subcutaneous dextrose for rehydration of elderly patients – an evidence-based review

BMC Geriatrics

Anne-Marie Cassano¹  Tari Turner² 

[1]Rehabilitation and Aged Care Services, Kingston Centre, Cheltenham, Victoria, Australia

[2]Centre for Clinical Effectiveness, Monash Institute of Health Services Research, Monash Medical Centre, Clayton, Victoria, Australia

Others  :  858633
DOI  :  10.1186/1471-2318-4-2

 received in 2003-12-02, accepted in 2004-04-15,  发布年份 2004

【 摘 要 】

Background

In the Rehabilitation and Aged Care Services Program at Southern Health in Victoria, saline hypodermoclysis is a relatively common method of rehydration. However, there were questions about the safety and effectiveness of subcutaneous infusion of other fluids and, in particular, dextrose solutions. This review aimed to assess the safety and effectiveness of rehydration of elderly patients with subcutaneous 5% dextrose solutions compared with intravenous 5% dextrose solutions.

Methods

We searched the Cochrane Library, Medline, IDIS, CINAHL, Current Contents, Premedline, Australasian Medical Index, the Joanna Briggs Institute, the US National Guideline Clearinghouse and bibliographies of retrieved articles. Searching was undertaken in July 2003. Studies selected were primary studies (or systematic reviews of primary studies) providing evidence as to the effectiveness and safety of subcutaneous infusion of dextrose solutions for rehydration of elderly patients. We included articles published in English in the last 10 years. Data were extracted by a single researcher.

Results

From our search we identified 15 potentially relevant articles. We obtained the full text of these articles to determine their relevance. After application of the inclusion criteria, four articles remained for appraisal including one systematic review, two randomised controlled trials and one cohort study.

Conclusion

The four studies appraised all provide evidence that appropriate volumes of subcutaneous dextrose infusions (in the form of half-normal saline-glucose 5%, 40 g/L dextrose and 30 mmol/L NaCl, or 5% dextrose solution and 4 g/L NaCl, or two-thirds 5% glucose and one-third normal saline) can be used effectively for the treatment of dehydration, with similar rates of adverse effects to intravenous infusion. The evidence in this area is limited, and larger randomised controlled trials using validated outcome measures would be useful to confirm these results.

【 授权许可】

   
2004 Turner and Cassano; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.

【 参考文献 】

• [1]Dangers of hypodermoclysis Nutr Rev 1953, 11:232-234.
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