This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bruera, E. Articles by Palmer, J. L. Search for Related Content PubMed PubMed Citation Articles by Bruera, E. Articles by Palmer, J. L. Social Bookmarking                            What's this?

Effects of Parenteral Hydration in Terminally Ill Cancer Patients: A Preliminary Study

From The University of Texas M.D. Anderson Cancer Center, Houston, TX; Hospital Eva Peron, Rosario, Argentina; Instituto Nacional de Cancer, Santiago, Chile; Clinica de Dolor, Fundacion Santafe de Bogotá, Bogotá, Columbia; and Centro Regional de Medicina, Los Montalvos, Spain

Address reprint requests to Eduardo Bruera, MD, Department of Palliative Care and Rehabilitation Medicine, Unit 8, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030; e-mail: ebruera{at}mdanderson.org

PURPOSE: Most patients with cancer develop decreased oral intake and dehydration before death. This study aimed to determine the effect of parenteral hydration on overall symptom control in terminally ill cancer patients with dehydration.

PATIENTS AND METHODS: Patients with clinical evidence of mild to moderate dehydration and a liquid oral intake less than 1,000 mL/day were randomly assigned to receive either parenteral hydration with 1,000 mL (treatment group) or placebo with 100 mL normal saline administered over 4 hours for 2 days. Patients were evaluated for target symptoms (hallucinations, myoclonus, fatigue, and sedation), global well-being, and overall benefit.

RESULTS: Twenty-seven patients randomly assigned to the treatment group had improvement in 53 (73%) of their 73 target symptoms versus 33 (49%) of 67 target symptoms in the placebo group (n=22; P = .005). Fifteen (83%) of 18 and 15 (83%) of 18 patients had improved myoclonus and sedation after hydration versus eight (47%) of 17 and five (33%) of 15 patients after placebo (P = .035 and P = .005, respectively). There were no significant differences of improvement in hallucinations or fatigue between groups. When blinded to treatment, patients (17 [63%] of 77) and investigators (20 [74%] of 27) perceived hydration as effective compared with placebo in nine (41%) of 22 patients (P = .78) and 12 (54%) of 22 investigators (P = .15), respectively. The intensity of pain and swelling at the injection site were not significantly different between groups.

CONCLUSION: Parenteral hydration decreased symptoms of dehydration in terminally ill cancer patients who had decreased fluid intake. Hydration was well tolerated, and a placebo effect was observed. Studies with larger samples and a longer follow-up period are justified.

Supported by the Brown Foundation, Houston, TX; and the Tobacco Settlement Foundation.

Presented in part at the 40th Annual Meeting of the American Society of Clinical Oncology, New Orleans, LA, June 5-8, 2004.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				L. Radbruch, F. Strasser, F. Elsner, J. F. Goncalves, J. Loge, S. Kaasa, F. Nauck, P. Stone, and the Research Steering Committee of the European As Fatigue in palliative care patients -- an EAPC approach Palliative Medicine, January 1, 2008; 22(1): 13 - 32. [Abstract] [PDF]

				D. C. Currow, M. Agar, J. Tieman, and A. P. Abernethy Letter to the editor: Multi-site research allows adequately powered palliative care trials; web-based data management makes it achievable today Palliative Medicine, January 1, 2008; 22(1): 91 - 92. [PDF]

				D.M.W. Tse, K.S. Chan, W.M. Lam, K. Leu, and P.T. Lam The impact of palliative care on cancer deaths in Hong Kong: a retrospective study of 494 cancer deaths Palliative Medicine, July 1, 2007; 21(5): 425 - 433. [Abstract] [PDF]