International Consensus Recommendation Guidelines for Subcutaneous Infusions of Hydration and Medication in Adults: An e-Delphi Consensus Study.
Daphne Broadhurst, Marie Cooke, Deepa Sriram and 10 others
PMID 37406334WHAT IT FOUND
Experts agreed on 42 guidelines for subcutaneous infusions in adults, covering assessment, device placement, and monitoring.
They recommend using this route to preserve veins when IV access fails, with specific limits on rates and volumes. No patient outcomes were tested.
Key findings
01All 42 proposed recommendations achieved strong agreement from the expert panel in the first round, requiring only minor wording changes.
02Subcutaneous infusion is recommended as a vessel health preservation strategy for adults when IV access is difficult or fails.
03Infusion rates for medications should generally not exceed 5 mL/h unless specified by the manufacturer.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study relies on expert opinion and existing literature rather than new clinical trial data. The panel was small (11 members) and lacked representation from some regions and disciplines (e.g., pharmacists). The recommendations are based on low-to-moderate quality evidence, with many items graded as level V (expert opinion). No patient outcomes were measured to verify if these recommendations actually improve safety or efficacy in practice.
Declared interests
One author reports employment with Nipro Canada and a speaker honorarium from BD Canada. Another reports employment with Needle Calm. Funding for one author came from the Children's Hospital Foundation and the National Health and Medical Research Council.
The easy way to misread this
Do not interpret these recommendations as proven interventions that improve patient outcomes. They represent expert consensus on best practices based on limited evidence, not results from a clinical trial testing whether subcutaneous infusion is superior to IV infusion.