Hypodermoclysis (HDC) is a method of administering fluids or medication subcutaneously (under the skin), as opposed to intravenously (IV; into a vein) or intramuscularly (into a muscle). It is a viable option for many medications and fluids, especially if the individual is unable to take oral medication or if the individual has unsuitable veins for IV fluids. Benefits of subcutaneous administration of medication include lower pain (as there are fewer pain receptors), good irrigation, and lower proteolytic activity. However, the bioavailability of substances administered in this method is uncertain. In mild to moderate dehydration, HDC of fluids is a relatively accepted form of rehydration therapy, especially when other routes are inaccessible or ineffective. However, HDC can be a costly procedure, and its effectiveness is debated, with a lack of literature or evidence for effectiveness, especially in specific populations.– Therefore, the purpose of this report is to examine the clinical and cost effectiveness of HDC in frail patients or patients residing in long term care, as well as evidence-based guidelines regarding the use of HDC in these patients.

This report is an upgrade of a previous 2020 CADTH report titled “Hypodermoclysis for Frail Patients and Patients in Long Term Care: Clinical Effectiveness, Cost Effectiveness, and Guidelines”, therefore it summarizes and critically appraises the articles identified in that report.

Wells C, MacDougall D. Hypodermoclysis for Frail Patients and Patients in Long Term Care: A Review of Clinical Effectiveness, Cost Effectiveness, and Guidelines [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2020 Aug 31. PMID: 33347106.