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Subcutaneous hydration by hypodermoclysis

  • Jorge H. Lopez (a1) and Carlos A. Reyes-Ortiz (a2)


Subcutaneous hydration, or hypodermoclysis (HDC), is a very simple technique that should be practised more often by doctors and nurses who care for older patients. It involves less discomfort, generates less cost and has fewer adverse effects than the intravenous route and may reduce the need for admission to the emergency department. The main indication is the management of mild to moderate dehydration, and prevention of dehydration in patients who are intolerant of oral intake. It should not be administered in situations of severe dehydration, in emergency situations, or in patients with fluid overload. Isotonic or hypotonic solutions must be used with appropriate electrolytes. Certain medicines can be given simultaneously by HDC and this may be especially valuable in palliative care settings. In most cases there is no need to add hyaluronidase.


Corresponding author

Address for correspondence: Carlos A. Reyes-Ortiz, Department of Social & Behavioral Sciences, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard (EAD-711B), Fort Worth, Texas, 76107–2699, USA. Email:


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1Schen, RJ, Singer-Edelstein, M.Subcutaneous infusions in the elderly. J Am Geriatr Soc 1981; 29: 583–85.
2Schen, R.Letter: Response to: Hypodermoclysis – a victim of historical prejudice. Age Ageing 2005; 34: 656–57.
3Miller, M. Disorders of fluid balance. In Halter, JB, Ouslander, JG, Tinetti, M, Studenski, S (eds), Hazzard's Geriatric Medicine and Gerontology, 6th edn.New York: McGraw Hill Medical, 2009, pp. 1047–48.
4Harchelroad, F.Acute thermoregulatory disorders. Clin Geriatr Med 1993; 9: 621–39.
5Dardaine-Giraud, V, Lamande, M, Constans, T.Hypodermoclysis: benefits and indications in geriatrics. Rev Med Intern 2005; 26: 643–50.
6Worobec, G, Brown, MK. Hypodermoclysis therapy in a chronic care hospital setting. J Gerontol Nurs 1997; 6: 2328.
7Dall'Olio, G.Epidemia di colera asiatico del 1886 a Venezia. Esperienze di cura con l'ipodermoclisi. RIMeL IJLaM 2009; 5: 227–32.
8Daland, J.The treatment of cholera by hypodermoclysis and enteroclysis. Trans Am Climatolog Clin Assoc 1895; 10: 92104.
9Evans, G.Illustrative cases. Myelogenous leukaemia – preliminary report. Cal State J Med 1904; 2: 242–44.
10Bartlett, W.Painless hypodermoclysis. Ann Surg 1921; 73: 161–64.
11Israels, S, Wylie, K.The dangerous hypodermoclysis in infancy. Can Med Assoc J 1959; 80: 3132.
12Gill, S, Dasgupta, M, Rochon, P.Hypodermoclysis in the treatment of dehydration. Am Fam Physician 2001; 64: 1516.
13Schen, R.Letter: Subcutaneous infusions in the elderly. BMJ 1981; 282: 823–24.
14Berger, EY. Nutrition by hypodermoclysis. J Am Geriatr Soc 1984; 32: 199203.
15Abdulla, A, Keast, J.Hypodermoclysis as a means of rehydration. Nurs Times 1997; 93: 5455.
16Olde Rikkert, MG, Bogaers, MA, Bruijns, E.Hypodermoclysis, an undervalued rehydration method in geriatrics. Tijdschr Gerontol Geriatr 1994; 5: 197204.
17Dardaine, V, Ferry, M, Constans, T.Subcutaneous perfusion of hypodermoclysis: a useful rehydration method in geriatrics. Presse Med 1999; 28: 2246–50.
18Hypodermoclysis Working Group. Hypodermoclysis: Guidelines on the technique. Wrexham: CP Pharmaceuticals, 1998.
19Barua, P, Bhowmick, B.Hypodermoclysis – a victim of historical prejudice. Age Ageing 2005; 34: 215–17.
20Berger, EY. Nutrition by hypodermoclysis. J Am Geriatr Soc 1984; 32: 199203.
21Barton, A, Fuller, R, Dudley, N.Using subcutaneous fluids to rehydrate older people: current practices and future challenges. Q J Med 2004; 97: 765–68.
22Slesak, G, Schnurle, JW, Kinzel, E, Jakob, J, Dietz, K.Comparison of subcutaneous and intravenous rehydration in geriatric patients: a randomized trial. J Am Geriatr Soc 2003; 51: 155–60.
23Lybarger, EH. Hypodermoclysis in the home and long-term care settings. J Infus Nurs 2009; 32: 4044.
24Walsh, G.Hypodermoclysis: an alternate method for rehydration in long-term care. J Infus Nurs 2005; 28: 123–29.
25Fonzo-Christe, C, Vukasovic, C, Wasilewski-Rasca, AF, Bonnabry, P.Subcutaneous administration of drugs in the elderly: survey of practice and systematic literature review. Palliat Med 2005; 19: 208–19.
26Arinzon, Z, Feldman, J, Fidelman, Z, Gepstein, R, Berner, YN. Hypodermoclysis (subcutaneous infusion) effective mode of treatment of dehydration in long-term care patients. Arch Gerontol Geriatr 2004; 38: 167–73.
27Cerchietti, L, Navigante, A, Sauri, A, Palazzo, F.Hypodermoclysis for control of dehydration in terminal-stage cancer. Int J Palliat Nurs 2000; 6: 370–74.
28Mancini, I, Body, JJ. Hypodermoclysis, a neglected approach. Rev Med Brux 1998; 4: A32731.
29Bruera, E, Legris, MA, Kuehn, N, Miller, MJ. Hypodermoclysis for the administration of fluids and narcotic analgesics in patients with advanced cancer. J Pain Symptom Manag 1990; 5: 218–20.
30Yap, LK, Tan, SH, Koo, WH. Hypodermoclysis or subcutaneous infusion revisited. Singapore Med J 2001; 42: 526–29.
31Schen, RJ, Edelstein-Singer, M.Hypodermoclysis in the home. J Am Geriatr Soc 1984; 32: 944.
32Jones, D, McGeorge, S.Subcutaneous infusion. Nurs Older People 2007; 19: 18.
33Moriarty, D, Hudson, E.Hypodermoclysis for rehydration in the community. Br J Community Nurs 2001; 6: 437–43.
34Rochon, PA, Gill, SS, Litner, J, Fischbach, M, Goodison, AJ, Gordon, M.A systematic review of the evidence for hypodermoclysis to treat dehydration in older people. J Gerontol A Biol Sci Med Sci 1997; 52: M16976.
35Turner, T, Cassano, AM. Subcutaneous dextrose for rehydration of elderly patients – an evidence-based review. BMC Geriatrics 2004; 4: 2.
36Sasson, M, Shvartzman, P.Hypodermoclysis: an alternative infusion technique. Am Fam Physician 2001; 64: 1575–78.
37Hays, H.Hypodermoclysis and system management. Can Fam Physician 1993; 39: 245.
38Schen, R, Arieli, S.Administration of potassium by subcutaneous infusion in elderly patients. BMJ 1982; 285: 1167–68.
39Bruera, E, Brenneis, C, Michaud, M et al. Use of subcutaneous route for the administration of narcotics in patients with cancer pain. Cancer 1988; 62: 407–11.
40Woodall, H.Alternatives to rehydration during hypodermoclysis. Am Fam Physician 2002; 66: 28.
41Frisoli Junior, A, de Paula, AP, Feldman, D, Nasri, F.Subcutaneous hydration by hypodermoclysis. A practical and low cost treatment for elderly patients. Drugs Aging 2000; 16: 313–19.
42Desmidt, T, Constans, T.Subcutaneous infusion of esomeprazole in elderly patients in palliative care: a report of two cases. J Am Geriatr Soc 2009; 57: 1724–25.
43Champoux, N, Du Souich, P, Ravaoarinoro, M, Phaneuf, D, Latour, J, Cusson, JR. Single-dose pharmacokinetics of ampicillin and tobramycin administered by hypodermoclysis in young and older healthy volunteers. Br J Clin Pharmacol 1996; 42: 325–31.
44Woodall, HE. Alternatives to rehydration during hypodermoclysis. Am Fam Physician 2002; 66: 28; author reply (Sasson M & Shvartsman P) 28, 30.
45Remington, R, Hultman, T.Hypodermoclysis to treat dehydration: a review of the evidence. J Am Geriatr Soc 2007; 55: 2051–55.
46Molloy, W, Cunje, A.Hypodermoclysis in the care of older adults: an old solution for new problems? Can Fam Physician 1992; 38: 2038–43.
47Dutertre, JP, Constans, T.L-hypodermoclyse: une technique oubliee. Rev Med Intern 1991; 12: 153–55.
48Jain, S, Mansfield, B, Wilcox, MH. Subcutaneous fluid administration – better than the intravenous approach? J Hosp Infect 1999; 41: 269–72.
49O'Keeffe, ST, Geoghegan, M.Subcutaneous hydration in the elderly. Ir Med J 2000; 93: 197–98.
50Schen, RJ, Singer-Edelstein, M.Hypodermoclysis. JAMA 1983; 250: 1694–95.
51Challiner, YC, Jarrett, D, Hayward, MJ, Al-Jubouril, MA, Julious, SA. A comparison of intravenous and subcutaneous hydration in elderly acute stroke patients. Postgrad Med J 1994; 70: 195–97.
52Mongardon, N, Le Manach, Y, Lescot, T, Langeron, O, Tresallet, C.Subcutaneous hydration: a potentially hazardous route. Eur J Anesthesiol 2008; 25: 771–72.
53O'Hanlon, S, Sheahan, P, McEneaney, R.Severe haemorrhage from a hypodermoclysis site. Am J Hosp Palliat Care 2009; 26: 135–36.
54Gluck, SM. Hypodermoclysis revisited. JAMA 1982; 248: 1310–11.
55Young, J. Administration of subcutaneous fluids (Hypodermoclysis). Bolton NHS Primary Care Trust. May 2007; 2: 1–9; available at: (accessed 15 December 2009).


Subcutaneous hydration by hypodermoclysis

  • Jorge H. Lopez (a1) and Carlos A. Reyes-Ortiz (a2)


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