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SAN DIEGO Although fluid intake can be safely increased in nursing home residents who have, or are at risk for, pressure ulcers and do not routinely ingest the prescribed amount of fluid, levels of subcutaneous oxygen may remain low, results from a multicenter study demonstrated.
"In the nursing home population, hydration is a serious issue," Nancy A. Stotts, R.N., Ed.D., said at the annual meeting of the Wound Healing Society. "Some of the estimates are that up to half of all nursing home residents are underhydrated."
The investigators recorded routine fluid intake for 5 days in 64 residents of five nursing homes in Northern California. The residents were then randomized to receive, for 5 days, the target amount of fluid prescribed by their physician or the target amount plus 10 mL/kg of body weight, said Dr. Stotts, professor of nursing at the University of California, San Francisco.
They also evaluated levels of subcutaneous oxygen in all study participants for 3 days during treatment. Hypovolemia was defined as 45 mm Hg or less, or a less-than-20% increase in response to an oxygen challenge.
Patients' mean age was 79 years; most were female (38) and cognitively impaired (51). Mean baseline daily fluid intake was 1,374 cc for the group who received prescribed fluid, and 1,707 cc for those who were randomized to the extra fluid. After treatment, the mean daily fluid intake increased significantly for both groups: to 1,787 cc for the group who received prescribed fluid, and to 2,380 cc for those who received the extra fluid.
The mean level of subcutaneous oxygen, however, was 40 mm Hg for patients in the target prescribed group, and 36 mm Hg for patients in the group that received supplemental fluid. Subcutaneous oxygen levels less than 45 mm Hg indicate tissue hypoxia that may be caused by hypovolemia, Dr. Stotts said at the meeting, which was held in conjunction with a symposium on advanced wound care.
No cases of fluid overload or heart failure were observed.
Increased fluid intake "did not reverse the low subcutaneous oxygen, perhaps because of chronic underhydration and osmoreceptor reset," she said. "Further work needs to address the optimal dose and duration of fluid for older adults and other factors that contribute to the low subcutaneous oxygen."
The study was funded by the National Institutes of Health.
SAN DIEGO Although fluid intake can be safely increased in nursing home residents who have, or are at risk for, pressure ulcers and do not routinely ingest the prescribed amount of fluid, levels of subcutaneous oxygen may remain low, results from a multicenter study demonstrated.
"In the nursing home population, hydration is a serious issue," Nancy A. Stotts, R.N., Ed.D., said at the annual meeting of the Wound Healing Society. "Some of the estimates are that up to half of all nursing home residents are underhydrated."
The investigators recorded routine fluid intake for 5 days in 64 residents of five nursing homes in Northern California. The residents were then randomized to receive, for 5 days, the target amount of fluid prescribed by their physician or the target amount plus 10 mL/kg of body weight, said Dr. Stotts, professor of nursing at the University of California, San Francisco.
They also evaluated levels of subcutaneous oxygen in all study participants for 3 days during treatment. Hypovolemia was defined as 45 mm Hg or less, or a less-than-20% increase in response to an oxygen challenge.
Patients' mean age was 79 years; most were female (38) and cognitively impaired (51). Mean baseline daily fluid intake was 1,374 cc for the group who received prescribed fluid, and 1,707 cc for those who were randomized to the extra fluid. After treatment, the mean daily fluid intake increased significantly for both groups: to 1,787 cc for the group who received prescribed fluid, and to 2,380 cc for those who received the extra fluid.
The mean level of subcutaneous oxygen, however, was 40 mm Hg for patients in the target prescribed group, and 36 mm Hg for patients in the group that received supplemental fluid. Subcutaneous oxygen levels less than 45 mm Hg indicate tissue hypoxia that may be caused by hypovolemia, Dr. Stotts said at the meeting, which was held in conjunction with a symposium on advanced wound care.
No cases of fluid overload or heart failure were observed.
Increased fluid intake "did not reverse the low subcutaneous oxygen, perhaps because of chronic underhydration and osmoreceptor reset," she said. "Further work needs to address the optimal dose and duration of fluid for older adults and other factors that contribute to the low subcutaneous oxygen."
The study was funded by the National Institutes of Health.
SAN DIEGO Although fluid intake can be safely increased in nursing home residents who have, or are at risk for, pressure ulcers and do not routinely ingest the prescribed amount of fluid, levels of subcutaneous oxygen may remain low, results from a multicenter study demonstrated.
"In the nursing home population, hydration is a serious issue," Nancy A. Stotts, R.N., Ed.D., said at the annual meeting of the Wound Healing Society. "Some of the estimates are that up to half of all nursing home residents are underhydrated."
The investigators recorded routine fluid intake for 5 days in 64 residents of five nursing homes in Northern California. The residents were then randomized to receive, for 5 days, the target amount of fluid prescribed by their physician or the target amount plus 10 mL/kg of body weight, said Dr. Stotts, professor of nursing at the University of California, San Francisco.
They also evaluated levels of subcutaneous oxygen in all study participants for 3 days during treatment. Hypovolemia was defined as 45 mm Hg or less, or a less-than-20% increase in response to an oxygen challenge.
Patients' mean age was 79 years; most were female (38) and cognitively impaired (51). Mean baseline daily fluid intake was 1,374 cc for the group who received prescribed fluid, and 1,707 cc for those who were randomized to the extra fluid. After treatment, the mean daily fluid intake increased significantly for both groups: to 1,787 cc for the group who received prescribed fluid, and to 2,380 cc for those who received the extra fluid.
The mean level of subcutaneous oxygen, however, was 40 mm Hg for patients in the target prescribed group, and 36 mm Hg for patients in the group that received supplemental fluid. Subcutaneous oxygen levels less than 45 mm Hg indicate tissue hypoxia that may be caused by hypovolemia, Dr. Stotts said at the meeting, which was held in conjunction with a symposium on advanced wound care.
No cases of fluid overload or heart failure were observed.
Increased fluid intake "did not reverse the low subcutaneous oxygen, perhaps because of chronic underhydration and osmoreceptor reset," she said. "Further work needs to address the optimal dose and duration of fluid for older adults and other factors that contribute to the low subcutaneous oxygen."
The study was funded by the National Institutes of Health.