Articolo del mese Ottobre 2016

Palliative Care and Hydration – a research from the Marie Curie Palliative Care Institute of Liverpool (UK)
The Association of Hydration Status with Physical Signs, Symptoms and Survival in Advanced Cancer — The Use of Bioelectrical Impedance Vector Analysis (BIVA) Technology to Evaluate Fluid Volume in Palliative Care: An Observational Study Authors: Amara Callistus Nwosu1*, Catriona R. Mayland1, Stephen Mason1, Trevor F. Cox2, Andrea Varro3, John Ellershaw1

1 Marie Curie Palliative Care Institute Liverpool (MCPCIL), University of Liverpool, Liverpool, United Kingdom, 2 Liverpool Cancer Trials Unit, University of Liverpool, Liverpool, United Kingdom, 3 School of Physiological Sciences, University of Liverpool, Liverpool, United Kingdom
Materials and methods: EFG ElectroFluidGraph Vector Impedance Analyser - Akern
People with advanced cancer commonly experience reduced oral intake in the last days of life. This may cause healthcare professionals and family caregivers to question whether clinically assisted hydration (CAH) is required for the management of hydration status and symptoms. In this study, hydration status was found to be associated with clinical signs and symptoms. Hydration status was normal in 43 (47.8%), ‘more-hydrated’ in 37 (41.1%) and ‘less hydrated’ in 10 (11.1%). Hydration status and pre-renal failure were independent predictors of survival. This is the first study to use BIVA to evaluate hydration and its relationship with symptoms and survival in advanced cancer patients. The findings demonstrate that hydration (as measured by H2/R and BIVA) in advanced cancer was significantly associated with physical signs (mucous membrane moisture, axilla dryness, sunken eyes, oedema), symptoms (dry mouth, thirst, unpleasant taste, fatigue) and oral fluid intake. Survival was statistically significantly shorter in ‘less-hydrated’ individuals and those with pre-renal failure.

Article available online PLOS ONE | DOI:10.1371/journal.pone.0163114 September 27, 2016