Hipodermóclise como alternativa para a reidratação em crianças
Barra lateral de artigos
Como Citar
Esta obra está licenciado com uma Licença Creative Commons Attribution 3.0 Unported License.
##plugins.themes.bootstrap3.displayStats.downloads##
Societal impact
Conteúdo do artigo principal
Resumo
A desidratação é uma das principais causas de mortalidade na população pediátrica em países em via de desenvolvimento. Por isso, se estudaram alternativas de manejo para a reidratação oral, intravenosa e intraóssea, de fácil aplicação e baixo custo. A hipodermóclise é a técnica para a administração subcutânea de líquidos com o fim de prevenir ou tratar a desidratação leve ou moderada; esquecida por muitos anos devido à falta de experiência e protocolos bem estruturados. Recentemente ressurge o interesse em investigar e implementar esta técnica graças a seus benefícios e menores riscos frente às outras opções, entre as que se encontram facilidade de aplicação, manutenção da via, comodidade do paciente e diminuição de complicações por dano endotelial, demostrados em diferentes estudos como é o caso do Infuse Peds 1 e 2. Para favorecer a absorção subcutânea se pode implementar a hialuronidase recombinante humana, enzima encargada de dissolver o ácido hialurônico para alterar, temporalmente, a permeabilidade do tecido, que é o objeto de análise dentro destes estudos. Na Colômbia esta técnica ainda não há sido completamente difundida para aplicá-la na população pediátrica. É imperativo divulgar opções de manejo que sejam efetivas e de baixo custo para a atenção das doenças mais prevalentes. A hipodermóclise cumpre com estes objetivos e conta, ademais, com benefícios como a satisfação dos pais e melhora índices de morbimortalidade infantil.
Detalhes do artigo
Referências
Humphrey P. Hypodermoclysis: An alternative to I.V. infusion therapy. Nursing. 2011; 41:16-17.
Barua P, Bhowmick BK. Hypodermoclysis: A victim of historical prejudice. Age and Ageing. 2005; 34:215–217.
Spandorfer PR. Subcutaneous rehydration. Updating a traditional technique. Pediatr Emerg Care. 2011; 27:230-236.
Jain S, Mansfield B, Wilcox MH. Subcutaneous fluid administration, better than the intravenous approach? J Hosp Infect. 1999; 41:269-272.
Enciso LF, Pareja DM. Hipodermoclisis: un tratamiento seguro, eficaz y de bajo costo para el manejo de pacientes [monografía]. Bogotá. Universidad Nacional de Colombia; 2009.
Camacho MI, Acevedo A, Santacruz JG. Uso del catéter subcutáneo (CS) en el programa de cuidado paliativo domiciliario de la Fundación Santa Fe de Bogotá. Rev Colombiana de Hematología y Oncología. 2012; 1:33.
Slesak G, Schnürle JW, Kinzel E, Jakob J, Dietz PK. Comparirson of subcutaneous and intravenous rehydration in geriatric patients: A randomized trial. J Am Geriatr Soc. 2003; 51: 155-160.
Arinzon Z, Feldman J, Fidelman Z, Gepstein R, Berner YN. Hypodermoclysis (subcutaneous infusion) effective mode of treatment of dehydration in long-term care patients. Arch Gerontol Geriatr. 2004; 38:167-173.
Lybarger EH. Hypodermoclysis in the home and long-term care settings. J Infus Nurs. 2009; 32:40-44.
Brugnolli A, Bevilacqua A, Clodig M. Hypodermoclysis hydration in the elderly. Assist Inferm Ric. 2012; 31:145-150.
Niescierenko M, Bachur R. Advances in pediatric dehydration therapy. Curr Opin Pediatr. 2013; 25:304–309.
Jiménez S, Rodríguez J. Deshidratación aguda. Rehidratación Bol Pediatr. 2006; 46:84-90.
Centro Nacional de Investigación y Tecnologías en Salud (Cinets). Guía de práctica clínica para prevención, diagnóstico y tratamiento de la enfermedad diarreica aguda en niños menores de 5 años. Bogotá. Ministerio de Salud y Protección Social Colciencias; 2013.
WHO. The treatment of diarrhea. A manual for physicians and other senior health workers. Department of Child and Adolescent Health and Development. Geneva: WHO; 2005. Disponible en: http://whqlibdoc.who.int/publications/2005/9241593180.pdf?ua=1.
Botas I, Ferreiro A, Soria B. Deshidratación en niños. An Med (Méx.) 2011; 56:146-155.
Canavan A, Arant B. Diagnosis and management of dehydration in children. Am Fam Physician. 2009; 80:692-696.
Jablonski S. Oral rehydration of the pediatric patient with mild to moderate dehydration. J Emerg Nurs. 2012; 38:185-187.
Kuensting L. Comparing subcutaneous fluid infusion with intravenous fluid infusion in children. J Emerg Nurs. 2013; 39:86-91.
Rouhani S, Meloney L, Ahn R, Nelson BD, Burke TF. Alternative rehydration methods: A systematic review and lessons for resource-limited care. Pediatrics. 2011; 127:e748-757.
Lopez JH, Reyes-Ortiz CA. Subcutaneous hydration by hypodermoclysis. Reviews in Clinical Gerontology. 2010; 1:9.
Turner T, Cassano AM. Subcutaneous dextrose for rehydration of elderly patients- an evidencebased review. BMC Geriatr. 2004; 15;4:2.
Huffman G.B. Hypodermoclysis: A cure for moderate dehydration. Am Fam Physician. 1999; 59:2617-2620.
Yap LK, Tan SH, Koo WH. Hypodermoclysis or subcutaneous infusion revisited. Singapore Med J. 2001; 42:526-529.
Gaisford W, Evans DG. Hyaluronidase in paediatric therapy. Lancet. 1949; 2:505-507.
Cubero MI, Machado IS, Fernández ME. Deshidratación aguda en pediatría. Actualización del protocolo de rehidratación en el SUE. Bol SPAO. 2013; 7:148-153.
Challiner YC, Jarrett D, Hayward MJ, al-Jubouri MA, Julious SA. A comparison of intravenous and subcutaneous hydration in elderly acute stroke patients. Postgrad Med J. 1994; 70:195-197.
Lininger RA. Pediatric peripheral I.V. insertion success rates. Pediatr Nurs. 2003; 29:351-354.
King CK, Glass R, Bresee JS, Duggan C, Centers for Disease Control and Prevention. Managing acute gastroenteritis among children: Oral rehydration, maintenance, and nutritional therapy. MMWR Recomm Rep. 2003; 52:1-16.
Spandorfer PR, Alessandrini EA, Joffe MD. Oral versus intravenous rehydration of moderately dehydrated children: A randomized, controlled trial. Pediatrics. 2005; 115:295-301.
Thomas JR, Yocum RC, Haller MF. Assessing the role of human recombinant hyaluronidase in gravity-driven subcutaneous hydration: The INFUSE-LR study. J Palliat Med. 2007; 10:1312-1320.
Schen RJ, Singer-Edelstein M. Subcutaneus infusions in the elderly. J Am Geriatr Soc. 1981; 29:583-585.
Cook LS. Infusion-related air embolism. J Infus Nurs. 2013; 36:26-36.
Bautista-Eugenio V, Salinas-Cruz J. La vía subcutánea opción para el paciente terminal cuando se pierde la vía oral. Rev Enferm Inst Mex Seguro Soc. 2009; 17:149-152.
Sasson M, Shvartzman P. Hypodermoclysis: An alternative infusion technique. Am Fam Physician. 2001; 64:1575–1578.
Hays H. Hypodermoclysis for symptom control in terminal care. Can Family Physician. 1985; 31:1253–1256.
Fallabela R, Escobar CE, Barona MI. Estructura y funciones de la piel. En Falabella R, Chaparro JV, Barona MI, Domínguez L. Dermatología. 6. ed. Medellín: CIB; 2002. p.2-15.
Pirrello RD, Ting Chen C, Thomas SH. Initial experiences with subcutaneous recombinant human hyaluronidase. J Palliat Med. 2007; 10:861-864.
Meyer K. The biological significance of hyaluronic acid and hyaluronidase. Physiol Rev. 1947; 27:335-359.
Chain E, Duthie E. Identity of hyaluronidase as spreading factor. Br J Exp Pathol. 1940; 21:324- 338.
Dolamore M. The use of hypodermoclysis without hyaluronidase. J Am Med Dir Assoc. 2009. 1:75.
Yocum RC, Kennard D, Heiner LS. Assessment and implication of the allergic sensitivity to a single dose of recombinant human hyaluronidase injection: A double-blind, placebocontrolled clinical trial. J Infus Nurs. 2007; 30:293–299.
Dychter SS, Ebel D, Mead TR, Yocum RC. Comparison of the tolerability of recombinant human hyaluronidase normal saline and recombinant human hyaluronidase lactated ringer’s solution administered subcutaneously: A phase IV, double-blind, randomized pilot study in healthy volunteers. Curr Ther Res Clin Exp. 2009; 70:421–438.
Wasserman RL. Overview of recombinant human hyaluronidase-facilitated subcutaneus infusión of IgG in primary immunodeficiencies. Immunotherapy. 2014; 6:553-567.
Slesak G, Schnürle JW, Kinzel E, Jakob J, Dietz PK. Subcutaneous and intravenous infusions were similarly well accepted, safe, and feasible in older patients with Dehydration. J Am Geriatr Soc. 2003; 51:155–160.
Gallardo R, Gamboa F. Uso de la vía subcutánea en cuidados paliativos. Monografías Secpal. 2013; (4): 48-56.
Eldridge DL. Alternatives to intravenous rehydration in dehydrated pediatric patients with difficult venous access. Pediatr Emerg Care. 2010; 26:529-535.
Gluck SM. Hypodermoclysis revisited. JAMA. 1982; 248:1310-1311.
Allen CH, Etzwiler LS, Miller MK, Maher G, Mace S, Hostetler MA, et al. Recombinant human hyaluronidase-enabled subcutaneous pediatric rehydration. Pediatrics. 2009; 124:e858–867.
Spandorfer PR, Mace SE, Okada PJ, Simon HK, Allen CH, Spiro DM, et al. A randomized clinical trial of recombinant human hyaluronidase-facilitated subcutaneous versus intravenous rehydration in mild to moderately dehydrated children in the emergency department. Clinical Therapeutics. 2012; 34: 2232-2245.
Cáceres DC, Estrada E, De Antonio R, Peláez D. La enfermedad diarreica aguda: un reto para la salud pública en Colombia. Rev Panam Salud Pública. 2005; 17:6-14.