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Association between parenteral fluids and symptoms in hospital end-of-life care: an observational study of 280 patients
  1. Anna Fritzson1,
  2. Björn Tavelin1 and
  3. Bertil Axelsson2
  1. 1Department of Radiation Sciences, Umeå University, Umeå, Sweden
  2. 2Department of Radiation Sciences, Unit of Clinical Research Center—Östersund, Umeå University, Umeå, Sweden
  1. Correspondence to Dr Anna Fritzson, Department of Radiation Sciences, Umeå University, Umeå S-901 87, Sweden; annafritzson{at}hotmail.com

Abstract

Objectives To investigate whether dying patients receiving parenteral fluids (PF) suffer from more or less symptoms than patients who do not receive PF. Today's evidence on how PF affects palliative patients’ symptoms is very scarce. Nevertheless, 40% of the patients who die expectedly in Swedish hospitals receive PF during their last 24 h of life.

Methods A historical cohort study of medical records was performed. Of the 530 patients who were reported to have died expectedly at hospital in Västerbotten county (Sweden) between 1 January 2011 and 30 June 2012, 140 cases who had received PF and 140 controls who had not received PF were identified by stratified randomisation and matched by age, sex and main disease. The groups were compared regarding documented presence of dyspnoea, respiratory secretions, anxiety, nausea and confusion during the last 24 h and the last week of life.

Results The prevalence of documented dyspnoea in the PF groups was higher than in the non-PF groups (51% vs 22% last 24 h, p<0.0001; 70% vs 45% last 7 days, p<0.001). The proportions of patients suffering from dyspnoea increased with larger administered volume. Although our main hypothesis—that the prevalence of respiratory secretions would be higher in the PF group—was not confirmed, we found a tendency in that direction (63% vs 50% last week, p=0.072). No clinically significant differences in anxiety, nausea or confusion were found.

Conclusions There is an association between PF administration and increased frequency of documented dyspnoea for terminally ill patients in their last week of life.

  • Palliative Care
  • Fluid Therapy
  • Nutrition Therapy
  • Symptom
  • Received 28 March 2013.
  • Revision received 1 October 2013.
  • Accepted 10 October 2013.

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  • Received 28 March 2013.
  • Revision received 1 October 2013.
  • Accepted 10 October 2013.
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