Background: Hydration therapy is essential in the care of the older patient. Subcutaneous (SC) hydration is a relevant method for parenteral hydration, but clinical trials on the subject have methodological shortcomings compared to updated standards.
Design: Assessor-blinded, non-inferiority RCT to explore if SC is a safe alternative to intravenous (IV) hydration.
Participants: Eligible patients were: Admitted patients 65 years or older with a need for parenteral hydration. The targeted sample size was 67 patients in each group.
Intervention: Patients were randomised to parenteral hydration via an IV or SC catheter during a 24 hours observation period. The non-randomised catheter (inactive) was placed as a sham on the patient, thereby blinding the caregivers and outcome assessors.
Measurement: Our primary outcome was the proportion of patients reporting at least one adverse effect with a non-inferiority calculation using a 20% margin.
Results: We included 51 patients, with 24 randomised to SC and 27 to IV. We were unable to reach our target sample size due to challenges in recruitment, time limitation, and COVID-19. For the outcome of adverse effects, SC was non-inferior to IV (p = 0.012). Time spent on inserting the catheters was shorter with SC (p = 0.001). The groups did not differ by pain of insertion, discomfort during infusion, or the risk of developing delirium.
Conclusion: SC is a safe alternative to IV hydration, is faster to place and should be an available method for parenteral hydration wherever older adults are cared for.
Trial Registration: ClinicalTrials.gov Identifier: NCT03710408.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1093/ageing/afab193 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Letter to the Editor: "ESPEN Guideline on Nutrition and Hydration in Dementia-Update 2024".
Clin Nutr
January 2025
Universidade Federal do Piauí, Picos, Piauí, Brazil.
Chronic Intestinal Failure and Short Bowel Syndrome in Adults: The State of the Art.
GE Port J Gastroenterol
December 2024
GENE - Artificial Feeding Team, Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal.
Background: Short bowel syndrome (SBS) is a devastating malabsorptive condition and the most common cause of chronic intestinal failure (CIF). During the intestinal rehabilitation process, patients may need parenteral support for months or years, parenteral nutrition (PN), or hydration/electrolyte supplementation, as a bridge for the desired enteral autonomy.
Summary: Several classification criteria have been highlighted to reflect different perspectives in CIF.
Home Parenteral Support in Chronic Intestinal Failure-First Results from a Pioneer Portuguese Intestinal Failure Center.
Nutrients
November 2024
GENE-Artificial Feeding Team, Gastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal.
Background/objectives: Home parenteral support (HPS) is the core of chronic intestinal failure (IF) treatment. For legal reasons, HPS in Portugal lags behind other European countries, and only a few patients were taken care of at home by nurses. Now, the legislation has changed, allowing patient self-care.
View Article and Find Full Text PDFTargeted nanoliposomes of oncogenic protein degraders: Significant inhibition of tumor in lung-cancer bearing mice.
J Control Release
December 2024
College of Pharmacy and Health Sciences, St. John's University, Queens, NY 11439, USA. Electronic address:
Article Synopsis
- Around 60% of non-small cell lung cancer (NSCLC) cases express the epidermal growth factor receptor (EGFR), making it a key target for treatment, but resistance to EGFR inhibitors develops quickly and poses challenges for patients.
- Researchers are exploring a new approach using a technique called "Proteolysis Targeting Chimeras (PROTACs)" to simultaneously degrade EGFR and Bromodomain-containing protein 4 (BRD4), which has shown promising results in cell tests with significant tumor growth inhibition.
- A specialized formulation, T-BEPRO, utilizing nanoliposomal carriers for delivering these PROTACs, demonstrated improved drug delivery and efficacy in reducing tumor size in mice, outperforming traditional individual drug treatments
ASPEN international survey on ethical competencies dealing with decision-making in the use of artificially administered nutrition and hydration and competency application in clinical practice.
Nutr Clin Pract
December 2024
Ipanema Research Trust, Auckland, New Zealand.
Background: Ethical competencies dealing with decision-making for clinicians involved in artificially administered nutrition and hydration (AANH) have not been defined in the literature. Although clinical assessments identify nutrition needs and appropriate routes of nutrition administration, an assessment of the ethical, cultural, and spiritual implications of the medical nutrition therapy may be overlooked.
Methods: Eleven competency statements were developed by members of two international sections of the American Society for Parenteral and Enteral Nutrition.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!