Hypodermoclysis for hydrating children with difficult venous access
Abstract:
Objective: Hypodermoclysis is an alternative for hydrating children with difficult venous access. This study aimed to map the literature on its use for fluid administration in neonates, infants, and children up to 12 years old in hospital settings.
Methods: A scoping review was conducted on December 4, 2024, and updated on July 25, 2025, in PubMed, Scopus, Web of Science, and CINAHL. Primary studies on hospitalized children (0 to 12 y) receiving fluids through hypodermoclysis were included. Two reviewers independently screened the articles.
Results: Ten studies, published between 1950 and 2025, were conducted in emergency, inpatient, and palliative care settings. The most used fluid was 0.9% sodium chloride; hyaluronidase was used in 8 studies. Outcomes most frequently assessed were safety (n=8), efficacy/effectiveness (n=4), and ease of use/comfort/satisfaction (n=3). The data demonstrate that hypodermoclysis is safe, with expected local adverse effects related to subcutaneous administration and rare severe local or systemic adverse effects. Moreover, dehydrated patients were successfully treated using this technique. The studies also indicate that hypodermoclysis is simple to perform, well accepted by health care professionals, facilitates parenteral rehydration with fewer needle insertions, and is satisfactory to caregivers.
Conclusion: Hypodermoclysis appears to be a safe, effective, and well-accepted option for pediatric dehydration. Its incorporation into pediatric clinical protocols may reduce the need for repeated venipuncture and associated distress, thereby improving patient comfort and family satisfaction.
Reference:
Silva MS, Sarinho BB, Feres TDS, Teixeira YF, Brassica SC, Rotta I, Visacri MB. Hypodermoclysis for Fluid Administration in Hospitalized Pediatric Patients: A Scoping Review. Pediatr Emerg Care. 2026 Jun 22. doi: 10.1097/PEC.0000000000003646. Epub ahead of print. PMID: 42318902.