Hipodermóclise como via alternativa: revisão integrativa da literatura

Abstract

The maintenance of hydration status and control analgesic is a challenge for institutions that care for elderly patients and cancer patients in terminal disease, especially when oral intake is not possible and venous access can be difficult. Hipodermóclise (HDC) or subcutaneous therapy (infusion of fluids and drugs subcutaneously) may be an alternative to intravenous (IV) in older people with cancer in advanced stage of disease. To review the literature in the period 2006 to 2011, about using the technique hipodermóclise as an alternative route for administration of fluids in nursing care. This is an integrative review, exploratory descriptive qualitative approach. We conducted a comprehensive search in the databases LILACS, SciELO, MEDLINE, and BDENF GOOGLE scholar with the descriptors hipodermóclise, hydration, skin and subcutaneous injection administration, with its written in Portuguese and English. Included in this review the articles found in its entirety, published in Portuguese, English and Spanish and indexed in the period 2006 to 2011. The sample consisted of twelve labors. Regarding the authorship of the articles revealed a 05 written by nurses, 03 by pharmacists, 02 physicians and 02 not quoted the profession. The location of performance of the authors, 05 service providers working in health care, 03 in hospitals, 02 universities and 02 non-quoted from the workplace. In relation to language and the host country of publication was found 10 publications in English and 02 in Portuguese, with 05 publications in the United States of America, 03 European publications, 02 Brazilian and 01 from Japan published in American periodical. Upon analyzing the research designs used in the articles included in the integrative review, we found 10 studies in the literature review, 01 studies and 01 retrospective randomized clinical trial. The main indication is the management of mild to moderate dehydration and prevention of dehydration in patients who can not tolerate oral intake and venous network fragile and difficult. It should not be used in emergencies, severe dehydration, in patients with coagulopathies or fluid overload. Isotonic solutions, dextrose 5%, 0.9% saline and diluted electrolytes in solution can be administered. Few drugs may be administered safely by HDC. The maximum volume in a single path in 1500 ml of infusion in 24 hours, a total of 3 L in two places to an infusion rate of not more than 120 ml / h. The addition of 150 units of hyaluronidase provides an infusion rate faster with less risk of local reactions. The upper chest, abdomen, anterior and lateral thigh, scapular region and the dorsal arm is recommended. Should be performed rotation of the insertion site every 72 hours and the new site should be placed at least 2-3 cm away from the old site. Local reactions are mild and self-limited and should disappear after 4h, include swelling, pain and erythema.