Season 2 Episode 11: July 28, 2026 | Hypodermoclysis and Subcutaneous Hydration: The Underutilized Hydration Alternative

So let's go ahead and start out with the big question.

Why are we still talking about IV hydration first when the evidence may suggest that subcutaneous hydration may actually be a better option for many patients?

I think it's important to understand that, that intravenous hydration is an effective method of hydrating our patients.

The fluid gets pretty much where we want it fast.

We can give large volumes to our patients, so the patients, uh, with severe dehydration or with the shock of different types, they need a lot of fluid fast, and IV hydration is the correct choice when, uh, when the patient need this effective treatment.

However, especially in geriatric medicine, we have a lot of patients where their oral fluid intake is insufficient.

So they don't need large, uh, amounts of fluid.

They just need what they should be drinking but isn't.

So here we have a subcutaneous hydration as a way of giving them a liter or two a day with a very easy method of, of treating them.

Yeah.

So, so I-

So-

...

I, I disagree that, that subcutaneous hydration is the better option for all patients, but for some patients it is certainly a better option.

Thanks for that clarification.

So for infusion nurses who maybe never heard of or used hypodermoclysis, can you walk us through exactly what subcutaneous hydration is and why it's been underutilized for so many years?

So subcutaneous hydration is a technique where we place a, an access or a needle inside the subcutaneous tissue on patients, and then we infuse the f- fluid into the subcutaneous base, where it is absorbed into the, uh, bloodstream.

So there's, like, an extra step compared to intravenous hydration.

And IV hydration is, it, it works, intuitively works.

It's easy to understand.

And a lot of the patients we have need intravenous therapy anyway, so why make an extra access? So I think, I think there is, there is an absolute need for IV treatment.

There is an absolute need for IV hydration.

But there isn't an absolute need for subcutaneous hydration, so it's an add-on more than a necessity.

More.

I think that's why we don't use it.