Hydration in palliative care: When, how and why;Hidratación en cuidados paliativos: Cuándo, cómo, por qué

Medicina Paliativa

Volumn 14, Issue 2, 2007, Pages 104-120

  Puerta Ardiz, María Dolores ^a   Bruera, E ^b  

^a Centro de Cuidados Laguna   (Spain)

^b UNIVERSITY OF TEXAS   (United States)

Author keywords

Dehydration; Hypodermoclisis; Palliative care; Rehydration; Terminal illness

Indexed keywords

CANCER PATIENT; CONTROLLED STUDY; DEHYDRATION; ENTERIC FEEDING; FLUID INTAKE; HUMAN; INFECTION; MEDICAL DECISION MAKING; MEDICAL PRACTICE; MEDLINE; PALLIATIVE THERAPY; REHYDRATION; REVIEW; TERMINAL DISEASE;

EID: 34547163444     PISSN: 1134248X     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (100)

1. MacDonald N, Fainsinger R. Indications and ethical considerations in the hydration of patients with advanced cancer. In: Bruera E, Higginson I, editors. Caquexia- Anorexia in Cancer Patients. Oxford: Oxford University Press; 1996. p. 94-109
2. Ripamonti C, Gemlo BT. Methods for artificial feeding and drainage of the gastrointestinal tract. In: Bruera E, Higginson I, editors. Caquexia-Anorexia in Cancer Patients. Oxford: Oxford University Press; 1996. p. 141-57.
3. Alexander HR, Norton JA. Pathophysiology of cancer caquexia. In: Doyle D, Hanks GW, MacDonald N, editors. Oxford Textbook of Palliative Medicine. New York, NY: Oxford: Oxford University Press; 1993. p. 316-29.
4. Bruera E, Miller L, Mc Callion J, Mac Millan K, Krefting L, Hanson J. Cognitive failure (CF) in patients with terminal cancer: A prospective study. J Pain Symptom Manage 1992; 7: 192-5.
5. Coyle N, Adelhardt J, Foley KM, Portenoy RK. Character of terminal illness in the advanced cancer patient: Pain and other symptoms during the last four weeks of life. J Pain Symptom Manage 1990; 5: 83-93.
6. Pascual A. Síntomas sistémicos. Caquexia-Anorexia. En: Gómez Batiste X, Planas Domingo J, Roca Casa J, Viladiu Quemada P. (editores.): Cuidados Paliativos en Oncología. Barcelona: Jims; 1996. p. 221-7.
7. Parkash R. The family perspective on issues of hydration in terminal care. J Palliat Care 1997; 13: 2327.
8. Musgrave CF, Bartal N, Opstad J. Intravenous hydration for terminal patients. What are the attitudes of Israeli terminal patients, their families, and their health professionals? J Pain Symptom Manage 1996; 12: 47-51.
9. Morita T, Shima Y, Adachi I. Attitudes of Japanese physicians towards terminal dehydration: A nationwide study. J Clin Oncol 2002; 20: 4699-704.
10. Burge FI, King DB, Willison D. Intravenous fluids and the hospitalized dying: A medical last rite? Can Fam Physician 1990; 36: 883-886.
11. Levinsky NG. Fluids and electrolytes. En: Wilson JD, Braunwald E, Isselbacher KJ, et al. (editors): Harrison's principles of internal medicine. New York: Mac Graw-Hill; 1991. p. 279-89.
12. Oskvig RM. Special problems in the elderly: The aging kidney and liver. Chest 1999; 115 (5 Supl.): 158S-164S.
13. th ed. Philadelphia, Pa: WB Saunders; 1996. p. 297-313.
14. Fried LF, Palevsky PM. Hyponatremia and hypernatremia. Med Clin North Am 1997; 81: 585-609.
15. Bruera E, Belzile M, Watanabe S, Fainsinger RL. Volume de hydration in terminal cancer patients. Support Care Cancer 1996; 4: 147-50.
16. McDonald GA, Dubose TD. Hyponatremia in the cancer patient. Oncology (Huntingt) 1993; 7: 55-64.
17. Morita T, Hyodo I, Yoshimi T, Ikenaga M, Tamura Y, Yoshizawa A, et al. Artificial hydration therapy, laboratory findings, and fluid balance in terminally ill patients with abdominal malignancies. J Pain Symptom Manage 2006. Vol. 31 No 2: 130-9.
18. Gisbert A, Pascual A. Manifestaciones clínicas y biológicas de la deshidratación en el enfermo en fase terminal. Medicina Paliativa; 2000. 7; (4): 129-34.
19. th ed. New York, NY: McGraw-Hill; 1995. p. 210-32.
20. Ciccone A, Allegra JR, Cody RP, Roche LM. Age related differences in diagnoses within the elderly population. Am J Emerg Med 1998; 16: 43-8.
21. Hoffman NB. Dehydration in the elderly: Insidious and manageable. Geriatrics 1991; 46: 35-8.
22. Lavizo-Mourey R, Johnson J, Stolley P. Risk factors for dehydration among elderly nursing home residents. J Am Geriatr Soc 1988; 36: 213-8.
23. Seymur DG, Henschke PJ, Cape RD, Campbell AJ. Acute confusional states and dementia in the elderly: the roles of dehydratation/volume depletion, physical illness and age. Age Agein 1980; 9: 137-46.
24. Warren JL, Bacon WE, Harris T, McBean AM, Foley DJ, Phillips C. The burden and outcomes associated with the dehydration among US elderly, 1991; 84: 1265-9.
25. Burge FI. Dehydration symptoms of palliative care cancer patients. J Pain Symptom Manage 1993; 8: 454-64.
26. st ed. Philadephia, Pa: Lippincott-Raven; 1998. p. 589-602.
27. Eaton D, Bannister P, Mulley GP, Connolly M. Auxiliary sweating in clinical assessment of dehydration in elderly patients. BMJ 1994; 308: 1271.
28. Gross CR, Lindquist RD, Woolley AC, Garanieri R, Allard K, Webster B. Clinical indicators of deshydration severity in elderly patients. J Emerg Med 1992; 10: 267-74.
29. McGree S, Abernethy WB, Simel DL. Is this patient hypovolemic? JAMA 1999; 281: 1022-9.
30. Bruera E, Chadwick, Fox R, Hanson J, MacDonald N. Study of cardiovascular autonomic insufficiency in advanced cancer patients. Cancer Treat Rep 1986; 70: 1383-7.
31. Mercadante S, Ferrera P, Girelli D, Casuccio A. Patients' and relatives perceptions about intravenous and subcutaneous hydration. J Pain Symptom Manage 2005; 30 (4): 354-58.
32. Styczen T. The ABC of ethics. Lublin: Catholic University of Lublin; 1981.
33. nd edn. Milan: Vita e Pensiero; 1995.
34. Taboada P, Bruera E. Ethical decision-making on communication in palliative cancer care: A personalist approach. Support Care Cancer 2001; 9: 335-43.
35. Guillen F. Sindromes Geriatricos. En: Rodes J, Guardia J, eds. Medicina Interna. Barcelona: Masson; 1997. p. 3492-6.
36. Ellershaw JE, Sutcliffe JM, Saunders CM. Dehydration and dying patient. J Pain Symptom Manage 1995; 10: 192-7.
37. McCann RM, Hall WJ, Groth-Juncker A. Comfort care for terminally ill patients: The appropriate use of nutrition and hydration. JAMA 1994; 272: 1263-6.
38. Musgrave CF, Bartel N, Opstad J. The sedation of thirst in dying patients receiving IV hydration. J Palliative Care 1995; 11: 17-21.
39. Lawlor PG, Gagnon B, Mancini IL, Pereira JL, Hanson J, Juarez-Almanzor, et al. Occurrence, causes, and outcome of delirium in patients with advanced cancer: A prospective study. Arch Intern Med 2000; 160: 786-94.
40. Agostini JV, Leo-Summers LS, Inouye SK. Cognitive and other adverse effects of diphenhydramine use in hospitalized older patients. Arch Intern Med 2001; 161: 2091-7.
41. Fann JR, Roth-Roemer S, Burington BE, Katon WJ, Syrjala KL. Delirium in patients undergoing hematopoietic stem cell transplantation. Cancer 2002; 95: 1971-81.
42. Prieto JM, Blanch J, Atala J, Carreras E, Rovira M, Cirera E, et al. Psychiatric morbility and impact on hospital length of stay among hematologic cancer patients receiving stem-cell transplantation. J Clin Oncol 2002; 20: 1907-17.
43. Morita T, Tei Y, Tsunoda J, Inoue S, Chiljara S. Underlying pathologies and their associations with clinical features in terminal delirium of cancer patients. J Pain Symptom Manage 2001; 22: 997-1006.
44. Morita T, Tei Y, Tsunoda J, Inoue S, Chiljara S. Increased plasma morphine metabolites in terminally ill cancer patients with delirium: an intraindividual comparison. J Pain Symptom Manage 2002; 23: 107-13.
45. FrancisJ, Martin D, Kapoor WN. A prospective study of delirium in hospitalized elderly. JAMA 1990; 263: 1097-101.
46. Gross CR, Lindquist RD, Wooley AC, Granieri R, Allard K, Webster B. Clinical indicators of dehydration severity in elderly patients. J Emerg Med 1992; 10: 267-74.
47. Lawlor PG. The panorama of opioids-ralated cognitive dysfunction in patients with cancer: A critical literature appraisal. Cancer 2002; 94: 1836-53.
48. Fainsinger RL, Bruera E. Hypodermoclysis (HDC) for symptom control versus the Edmonton injector (EI). J Palliative Care 1991; 7: 5-8.
49. Fainsinger RL, Bruera E. The management of hydration in terminally ill patients. J Palliative Care 1995; 10: 55-9.
50. Bruera E, Franco JJ, Maltoni M, Watanabe S, Suarez-Almanzor M. Changing patterns of agitated impaired mental status in patients with advanced cancer: Association with cognitive monitoring hydration, and opioid rotation. J Pain Symptom Manage 1995; 10: 287-91.
51. Gagnon P, Allard P, Masse B, De Serres M. Delirium in terminal cancer: A prospective study using daily screenin, early diagnoses, and continuous monitoring. J Pain Symptom Manage 2000; 19: 412-26.
52. Maddocks I, Somogyi A, Abbott F, Hayball P, Parker D. Attenuation of morphine-induced delirium in palliative care by substitution with infusion of oxycodone. J Pain Symptom Manage 1996; 12: 182-9.
53. Tuma R, DeAngelis LM. Altered mental status in patients with cancer. Arch Neurol 2000; 57: 1727-31.
54. Breitbart W, Gibson C, Tramblay A. The delirium experience: Delirium recall and delirium-releated distress in hospitalized patients with cancer, their spouse/caregivers, and their nurses. Psychosomatics 2002; 43: 183-94.
55. Inouye SK, Bogardus ST Jr, Charpentier PA, Leo.Summers L, Acampora D, Holford TR, et al. A multicomponent intervention to prevent delirium in hospitalized older patients. N Engl J Med 1993; 340: 669-76.
56. Lawlor PG. Delirium and dehydration: some fluid for thought? Support Care Cancer 2002; 10: 445-54.
57. Fainsinger Rl, Bruera E. When to treat dehydration in terminally ill patient? Support Canre Cancer 1997; 5: 205-11.
58. Billings JA. Comfort measures for the terminally ill: Is deshydration painful? J am Geriatr Soc 1985; 33: 808-10.
59. Dahlin C, Goldsmith T. Dysphagia, dry mouth, and hiccups. In: Ferrell B, Coyle N, editors. Textbook of Palliative Nursing. New York, NY: Oxford University Press; 2001: 122-38.
60. Morita T, Tei Y, Inoue S, Suga A, Chihara S. Fluid status of terminally ill cancer patients with intestinal obstruction: An exploratory observational study. Support Care Cancer 2002; 10 (6): 474-9.
61. Morita T, Hyodo I, Yoshimi T, Ikenaga M, Tamura Y, Yoshizawa A, et al. Association between hydration volume and symptoms in terminally ill cancer patients with abdominal malignancies. Annals of Oncology 2005; 16: 640-7.
62. Lanuke K, Fainsinger RL, DeMoissac D. Hydration Management at the End of Life. J Palliative Medicine. 2004. 7 (2) :257-63.
63. Bruera E, Lawlor P. Definding palliative care interventions. J Palliat Care 1998; 14: 23-4.
64. Morita T, Hirai K, Sakaguchi Y, Tsuneto S, Shima Y. Family-perceived distress from delirium-related symptoms of terminally ill cancer patients. Psychosomatics 2004; 45: 107-13.
65. Bruera E, Sala R, Rico MA, Moyano J, Centeno C. Willey J, et al. A randomized placebo controlled trial of parenteral hydration in terminally ill cancer patients. J Clin Oncology 2005; 23: 2366-71.
66. Fainsinger RL, MacEachern T, Miller MJ, Bruera E, Spachynski K, Kuehn N, et al. The use of hipodermoclysis for rehydration in terminally ill cancer patients. J Pain Symptom Manage 1994; 9: 298-302.
67. Dunphy K, Finlay I, Rathbone G, Gilbert J, Hicks F. Rehydration in palliative and terminal care: If not-why not? 1995; 9: 221-8.
68. Dunlop RJ, Ellershaw JE, Baines MJ, Stykes N, Saunders CM. On whitholding nutricion and hydration in the terminally ill: Has palliative medicine gone too far? A reply. J Med Ethics 1995; 21: 141-3.
69. Diener JR, Coutinho MS, Zoccoli CM. Central venous catheter-related infections in critically ill patients. Rev Assoc Med Bras 1996; 42: 205-14.
70. Krzywda EA. Predisposing factors, prevention, and management of central venous catheter occlusions. J Intraven Nurs 1999; 22 (6 Supl.): S11-S17.
71. Yilmazlar A, Bilgin H, Korfail G, Eren A, Ozkan U. Complications of 1303 central venous cannulations. J R Soc Med 1997; 90: 319-21.
72. Lipman TO, Cass OW, Ho CS, Kearns PJ, Shikora SA. Group I: Choosing the appropriate method of placement of an enteral feeding tube in the high risk population. Nutr Clin Pract 1997; 12 (1 Supl.): S54-S55.
73. Day HB. The treatement of infantile diarrhea by saline injections. Practitioner 1913; 91: 58-64.
74. Berger EY. Nutrition by hypodermoclysis. J Am Geriatr Soc 1984; 32: 199-203.
75. Rochon 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: M169-M176.
76. Abbot WE, Levey S, Foreman RC, Krieger H, Holden WD. The danger of administering parenteral fluids by hypodermoclysis. Surgery 1952; 32: 305-15.
77. Slesak G, Schnurle JM, Kinzel E, Jackob J, Dietz PK. Comparison of subcutaneous and intravenous rehydration in geriatric patients: A randomized trial. J Am Geriatr Soc 2003; 51: 155-60.
78. Farrand S, Campbell AJ. Safe, simple subcutaneous fluid administration. Br J Hosp Med 1996; 55: 690-92.
79. Lipschitz S, Campbell AJ, Roberts MS, Wanwimolnk S, McQueen EG, McQuen M, et al. Subcutaneous fluid administration in elderly subjects: Validation of an under-used technique. J Am Geriatr Soc 1991; 39: 6-9.
80. Schen RJ, Singer-Edelstein M. Subcutaneous infusions in the elderly. J Am Geriatr Soc 1981; 29: 583-5.
81. O'Keeffe ST, Lavan JN. Subcutaneous fluids in elderly hospital patients with cognitive impairment. Gerontology 1996; 42: 36-9.
82. Hays H. Hypodermoclysis for symptom control in terminal cancer. Can Fam Physician 1985; 31: 1253-6.
83. Bruera E, Legris MA, Kuehn N, Miller MJ. Hypodermoclysis for the administration of fluids and narcotic analgesics in patients with advanced cancer. J Pain Symptom Manage 1990; 5: 218-20.
84. Llimos A, Sibina M, Porta J, Ylla-Catala E, Ferrer M. Utilization de la vía subcutánea en cuidados paliativos. Medicina Paliativa. 1999; 6 (3): 121-7.
85. Steiner N, Bruera E. Methods of hydration in palliative care patients. J Palliative Care 1998; 14: 6-13.
86. Waller A, Carolin NL. Subcutaneous infusions. In: Waller A, Carolin NL, editors. Handbook of Palliative Care in Cancer. Boston, Mass:Butterworth Heinemann; 1996. p. 449-56.
87. Sasson M, Schvartzman P. Hypodermoclysis: An alternative infusion technique. Am Fam Physician 2001; 64: 1575-8.
88. Bruera E, Brenneis C, Michaud M, Bacovsky R, Chadwick S, Emeno A, et al. Use of the subcutaneous route for the administration of narcotics in patients with cancer pain. Cancer 1988; 62: 407-11.
89. Bruera E, MacEachern T, Macmillan K, Miller MJ, Hanson J. Local tolerance to subcutaneous infusions of high concentrations of hydromorphone: A prospective study. J Pain Symptom Manage. 1993 May; 8 (4): 201-04.
90. Macmillan K, Bruera E, Kuehn N, Elmser P, Macmillan A. A prospective comparison study between a butterfly needle and a Teflon cannula for subcutaneous narcotic administration. J Pain ymptom Manage 1994; 9: 82-4.
91. Bruera E, de Stoutz N, Fainsinger RL, Spachynski K, Suarez-Almanzor M. Comparison of two different concentrations of hyaluronidase in patients receiving one-hour infusions of hypodermoclyisis. J Pain Symptom Manage 1995; 10: 505-9.
92. Constans T, Dutertre JP, Froge E. Hypodermoclsis in dehydrated elderly patients: Local effects with and without hyaluronidase. J Palliative Care. 1991; 7 (2): 10-2.
93. Ferry M, Dardaine V, Constans T. Subcutaneous infusion or hypodermoclysis: a partial approach. J Am Geriatr Soc 1999; 47: 93-5.
94. Centeno C, Bruera E. Subcutaneous hydration with no hyaluronidase in patients with advanced cancer. J Pain Symptom Manage 1999; 17 (5): 305-6.
95. Bruera E, Neumann CM, Pituskin E, Calder K, Hanson J. A randomized controlled trial of local injections of hyaluronidase versus placebo in cancer patients receiving subcutaneous hydration. Ann Oncol 1999; 10 (10): 1255-8.
96. Salim A, Crowe M, O'Keeffe ST. Subcutaneous hydration in the elderly. In: Arnaud MJ, Baumgartner RJ, Morley JE, Rosenberg IH, Vellas B, editors. Hydration and Aging. New York, NY: Springer; 1998. p. 201-8.
97. Andreoli TE. Disorders of fluid volume, electrolyte and acid-base balance. In: Wyngaarden JB, Smith LH, Bennet JC, editors. Cecil Textbook of Medicine. Philadelphia, Pa; 1992: 499-528.
98. Bruera E, Schoeller T, Pruvost M. Proctoclysis for hydration of terminal cancer patients. Lancet 1994; 344: 1699.
99. Needham D. Proctoclysis for hydration. Lancet 1995; 345: 596.
100. Bruera E, Pruvost M, Schoeller T, Montejo G, Watanabe S. Proctoclysis for hydration of terminally ill cancer patients. J Pain Symptom Manage 1998; 15 (4): 216-9.