Indications to the use of subcutaneous route for fluids and drugs administration: a literature review

: . Indications to the use of subcutaneous route for fluids and drugs administration: a literature review.

Background: Hypodermoclysis is a practice valued in recent years for its safety. However, it continues to be underutilized.

Objective: To analyze the most recent evidences on the use of hypodermoclysis for fluids and drugs administration, evaluating its efficacy, safety and mode of use on the elderly population and palliative care patients.

Methods: Pubmed, Cochrane Central Register of Controlled Trials and CHINAL databases were searched with the keywords "hypodermoclysis, subcutaneous fluid, subcutaneous infusion"; studies published from 2020 onwards were included.

Results: No relevant new findings emerged compared to the knowledge already available but the number of evidences increased. The amount per infusion site should not exceed 1000 ml with a suggested hourly rate of 50 ml/hour in the elderly population. In the palliative, setting hypodermoclysis has emerged as a promising option to provide controlled rehydration, reducing the need for invasive interventions. Studies suggest that subcutaneous hydration carries a lower risk of agitation than intravenous hydration, a reduced rate of serious adverse events (1 per 270 infusions), and comparable results in terms of plasma osmolarity after 48 hours.

Conclusions: The technique is safe for administration of fluids and some drugs with fewer adverse effects than parenteral administration. Many aspects still need further studies but recommendations for safe use of this technique are already available.