Why don’t we do IV fluids in hospice? What’s the harm?

The short answer is that it only serves to prolong the inevitable. But maybe that’s exactly what you want (of course it is)!

The reality is that IV fluids in patients whose hearts/brains/livers/kidneys are shutting down can cause suffering.

Patients can become overloaded with fluid. Fluid in the absence of nutrients can lead to the blood vessels (veins) leaching fluid out into the other tissues, called Third Spacing, a poetic term for some bad shit. It means swelling and potentially an even lower blood pressure as fluid drains out of the vasculature.

Patients with hearts that don’t work well anymore can have fluid back up into their lungs, drowning them from the inside.

Patients with low sodium due to their other disease processes can have seizures if sodium, like the kind in IV fluids, is replaced too quickly.

Patients with liver issues can have a huge buildup of fluid in their abdomen, called ascites, which can cause pain and breathing issues.

And on and on.

As the body dies, patients stop taking in fluid. There’s a reason. The body is protecting itself from these things.

Letting that happen is ok. It’s mercy. It’s reality.

I, on the other hand, am hydrating.