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September 17, 1982

Hypodermoclysis Revisited

Author Affiliations

Far Rockaway, NY

JAMA. 1982;248(11):1310-1311. doi:10.1001/jama.1982.03330110018015

To the Editor.—  Contrary to some strongly held beliefs, documentation of adverse effects from hypodermoclysis is extremely limited. The older literature encompasses a few anecdotal reports of infection and tissue necrosis (particularly in neonates), as well as an experimental study involving seven patients who were given large quantities of electrolyte-free fluids. Four patients received 2,000 mL of 10% invert sugar-water solution subcutaneously within a period of 1 1/2 to 3 1/3 hours.1 All showed signs of sudden hypotension attributed to great osmotic shifts of water and electrolytes. The effects were nonetheless transient and self-limited in each case.Although hypodermoclysis is virtually unknown among younger generations of physicians and nurses, many years of cumulative experience testify to the fact that when properly used, clysis is an exceptionally safe and occasionally lifesaving means of fluid replacement, especially for older adults.2,3 This experience is supported by a recent study of 1,850