Department of Geriatric Medicine, Aalborg University Hospital, Aalborg, Denmark.
Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark.
PLoS One. 2022 Oct 10;17(10):e0275783. doi: 10.1371/journal.pone.0275783. eCollection 2022.
Subcutaneous (SC) hydration is a valuable method for treating dehydration in the very old patients. Data are absent on the absorption rate, and the availability of SC infused fluid in the circulation in this group of patients where SC hydration is particularly relevant.
We performed an explorative study on ill very old (range 78-84 years old) geriatric patients with comorbidities who received an SC infusion of 235 ml isotonic saline containing a technetium-99m pertechnetate tracer. The activity over the infusion site was measured using a gamma detector to assess the absorption rate from the SC space. The activity was measured initially every 5 minutes, with intervals extended gradually to 15 minutes. Activity in blood samples and the thyroid gland was measured to determine the rate of availability in the circulation.
Six patients were included. The mean age was 81 years (SD 2.1), the number of comorbidities was 4.6 (SD 1.3), and the Tilburg frailty indicator was 3.8 (SD 2.4). When the infusion was completed after 60 minutes, 53% (95% CI 50-56%) of the infused fluid was absorbed from the SC space, with 88% (95% CI 86-90%) absorbed one hour later. The absorption rate from the SC space right after the completion of the infusion was 127 ml/h (95% CI 90-164 ml/h). The appearance of the fluid into the blood and the thyroid gland verified the transfer from SC to circulation.
This first explorative study of absorption of SC infused fluid in the very old found an acceptable amount of fluid absorbed from the SC space into the circulation one hour after infusion had ended. Results are uniform but should be interpreted cautiously due to the low sample size.
ClinicalTrials.gov Identifier: NCT04536324.
皮下（SC）补液是治疗非常老年患者脱水的一种有价值的方法。关于吸收速率以及在 SC 补液特别相关的这群患者中循环中 SC 输注液体的可用性，目前尚无数据。
我们对患有合并症的非常年老（78-84 岁）老年患者进行了一项探索性研究，这些患者接受了含有锝-99m 高锝酸盐示踪剂的 235 毫升等渗盐水的 SC 输注。使用伽马探测器测量输注部位的放射性活度，以评估从 SC 空间的吸收速率。最初每 5 分钟测量一次活性，然后逐渐延长至 15 分钟。测量血液样本和甲状腺中的放射性活度，以确定在循环中的可用性。
纳入了 6 名患者。平均年龄为 81 岁（标准差 2.1），合并症的数量为 4.6（标准差 1.3），蒂尔堡虚弱指数为 3.8（标准差 2.4）。60 分钟输注完成时，53%（95%置信区间 50-56%）的输注液体从 SC 空间被吸收，88%（95%置信区间 86-90%）在 1 小时后被吸收。输注完成后立即从 SC 空间吸收的速率为 127ml/h（95%置信区间 90-164ml/h）。液体进入血液和甲状腺的出现证实了从 SC 到循环的转移。
这项关于非常老年患者 SC 输注液体吸收的首次探索性研究发现，输注结束后 1 小时，从 SC 空间吸收到循环中的液体量可接受。结果是一致的，但由于样本量小，应谨慎解释。
ClinicalTrials.gov 标识符：NCT04536324。
