The use of clinically assisted hydration at the end of life (one of the most controversial issues in medicine) varies widely in clinical practice, ranging from 12% to 88% of cancer patients.

A new feasibility study concludes that clinically assisted hydration may modestly increase the life span of terminally ill cancer patients. The study included cancer patients in their last week of life who were unable to maintain sufficient oral fluid intake, compared with usual care to assisted hydration. Fluids were given either intravenously or by subcutaneous injection.
- For patients who received assisted hydration, the survival rate was 26% higher than for patients who did not receive assisted hydration — an average of an additional day and a half of life.
- Clinical outcomes were similar in both groups, but for patients receiving hydration there was a nonsignificant delay in the need for relevant “as-required" medication.
- The incidence of audible upper airway secretions was similar in both cohorts, but there was a significant delay in the need to dispense medication for those receiving hydration.
- Although clinically assisted hydration did not appear to reduce the frequency of hyperactive delirium, it did appear to delay its onset.

Clinical implications
- Practice must be evidence-based to provide the best possible palliative care.
- It is important to treat patients individually; fluids might worsen their symptoms or it might improve them.

See reference for more information.

Adapted from Medscape News & Perspective. Parenteral fluids in cancer patients at end of life. Internet. Available at https://www.medscape.com/viewarticle/891381?src=wnl_edit_tpal&uac=6705FY#vp_2. Accessed on February 7, 2018. To view the entire article and all other content on the Medscape News and Perspective site, a free, one-time registration is required.