Administration of fluids and antibiotics via hypodermoclysis in adult patients in palliative care: a scoping review
DOI:
https://doi.org/10.30968/jhphs.2025.161.1254Abstract
Objective: To map studies in the literature on the administration of fluids and antibiotics via hypodermoclysis in adult patients in palliative care. Methods: A scoping review was conducted, with a systematic search performed in July 2024 in the PubMed, Scopus, Web of Science and CINAHL databases. Primary studies evaluating the administration of fluids and antibiotics via hypodermoclysis in adult patients receiving palliative care were included. Two reviewers independently screened the titles and abstracts, followed by the full texts of the articles. Data from the selected studies were extracted and presented descriptively. Results: The database search resulted in 1,782 articles, of which 19 were included in this review. Observational studies stood out (n = 16). The majority exclusively included patients with advanced cancer (n = 11), with a mean age over 60 years (n = 17), and hospitalized (n = 12). Fluids were evaluated in 18 studies. The most commonly used fluids were 0.9% sodium chloride, either administered alone (n = 11) or in combination with 5% dextrose (n = 11). In most studies, the administered volumes ranged from 500 to 1,000 mL of fluids, delivered slowly and steadily, for average periods of up to 7 days. Mild adverse effects at the infusion site were commonly reported. The main benefits of fluid infusion via hypodermoclysis mentioned in the studies include effectiveness in hydration and symptom management, a lower risk of severe systemic complications, and comfort for the patient and their family. However, limitations were highlighted regarding the volume, infusion rate, and type of solution used, along with the frequent occurrence of local adverse effects. Three studies evaluated the use of antibiotics. None of them reported information about dosage, infusion rate, or treatment duration. Mild adverse effects observed included edema, hyperemia, and pain, with no data on effectiveness. Conclusion: The review highlighted the effectiveness and safety of hypodermoclysis for fluid administration but noted the lack of studies on the use of antibiotics with this technique in palliative care, emphasizing the need for further research in this area.
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