What is artificial hydration and nutrition?
may come during the course of your illness when you may eat and drink less. The
changes in your appetite and fluid intake may be related to your general
weakness and slowing metabolism. Some illnesses are associated with swallowing
difficulties or nausea and vomiting. It is important to talk to your doctor
about what to expect as your illness progresses.
If you are no
longer able to take food or fluids by mouth, an intravenous (IV) line or
feeding tube can be used to provide fluids and artificial nutrition. An IV is a
needle placed in your vein through which fluids, liquid nutritional
supplements, and medicines can be given. A feeding tube can be either a tube
inserted into the stomach through the nose (nasogastric tube, or NG tube) or a
tube surgically inserted through the abdomen into the stomach (gastrostomy or
PEG tube, or g-tube). As with an IV line, liquid nutritional supplements,
fluids, and medicines can be given through a feeding tube. Artificial hydration
can also be provided through hypodermoclysis, which involves the injection of
fluids directly into tissues beneath the skin (subcutaneous).
people with acute illness or injury, short-term use of IVs, hypodermoclysis,
and artificial feeding tubes can be helpful, and in some cases ongoing
hydration may be beneficial. For example, continuing hydration may help
maintain kidney function or avoid some of the side effects of medicine. But for
people facing a life-limiting illness, there may come a time when the risks of
artificial nutrition and hydration outweigh the benefits.
What are the benefits of artificial hydration and nutrition?
Some people facing a life-limiting illness may benefit
from receiving IV fluids, hypodermoclysis, or an artificial feeding tube. For
instance, it may be appropriate to use IV fluids, hypodermoclysis, or tube
feedings for illnesses that cause nausea and vomiting or impair the ability to
When used appropriately, artificial hydration or
nutrition may improve a person's energy and comfort level. But the benefits may
be temporary. It is important to talk about your treatment goals with your
doctor. What do you expect to achieve if you receive IV fluids,
hypodermoclysis, or artificial tube feedings?
Talk to your doctor
about your illness and whether IV fluids, hypodermoclysis, or artificial tube
feedings may improve the quality of your life.
What are the risks of artificial hydration and nutrition?
Both intravenous (IV) lines and artificial tube
feedings have some risks.
- You can get an infection at the site where
the IV is inserted.
- To reduce the likelihood of infection, the IV
site may be changed every few days. Having an IV inserted can be
- As your illness progresses and death nears, it is normal
for your body to not need as much food or fluid. Dehydration is a normal
occurrence at this time. If IVs are started during this process, your body may
not be able to handle the IV fluids. Swelling in your arms or legs may develop,
or you may develop fluid in your lungs, which makes breathing more
- Swelling may occur around the site where
the catheter is inserted.
- You may experience some pain or
discomfort near the infusion site, although this is uncommon.
can get an infection at the site where the catheter is
- Your body may not be able to handle the additional
fluids, causing fluid overloading. Other parts of your body may swell, or you
may get fluid in your lungs, which makes breathing more difficult. There is an
increased risk of
Artificial feeding tubes
develop when fluid from the stomach is aspirated, or inhaled, into the lungs.
- A tube that is surgically placed into the stomach through the
abdomen (gastrostomy or PEG tube, or g-tube) can become infected at the point
- The artificial feeding tube may irritate the lining
of the stomach, which occasionally can lead to the development of stomach
- It is normal for your metabolism to slow as death
approaches. If nutritional supplements are given during this time, digestive
problems can develop, such as bloating, heartburn, or indigestion.
Another problem associated with IVs or artificial
feeding tubes is the limits they pose on activity. Being connected to tubes may
limit your ability to walk or move around in a wheelchair. Hypodermoclysis can
in some cases avoid some of these limitations on movement.
What are the risks of not receiving artificial hydration and nutrition?
Artificial hydration or nutrition may improve the
quality of your life by increasing your energy. In some cases, artificial
hydration can decrease certain symptoms, such as nausea or weakness. If you
choose not to receive these treatments, you may be missing therapies that can
improve the quality of your remaining time.
If communication is
not clear between you and your loved ones and doctor, and you are unable to
communicate, medical treatment that does not follow your wishes may be chosen.
For instance, if you do not want artificial hydration or nutrition but have not
clearly communicated your wishes, IVs, hypodermoclysis, or tube feedings may be
started if you are unable to take food or fluids by mouth. For this reason, it
is very important to discuss your wishes about artificial hydration with your
doctor and family. State your wishes clearly, and put them in writing in an
If you need more information, see the topic
Writing an Advance Directive or
Care at the End of Life.