Association between respiratory symptoms and hydration volume in terminally ill cancer patients

We evaluated the association between respiratory symptoms and hydration volume during last 1 week of life in terminal cancer patients using retrospective study. The subjects were 138 terminally patients with malignancies. Patients were classified into two groups: the low hydration group (group L, n=85) who received 1,000 ml or less of artificial hydration per day in 1 week before death and high hydration group (group H, n=53) who received over 1,000 ml per day. We compared appearance of dyspnea and bronchial secretion on group L with group H. 64.1% of group H had dyspnea, and 52.8% had bronchial secretion. These fractions are significantly higher than group L (32.9%, 15.3%). In the results of multiple regression analysis, lung involvement (odds ratio: 3.55), hydration over 1,000 ml per day (3.54), and administration of opioid (0.40) were significantly related dyspnea. Lung involvement (7.29), hydration over 1,000 ml per day (4.43), and oral intake (0.31) were significantly related bronchial secretion. Our results provide preliminary evidence that excessive artificial hydration therapies influence the respiratory symptoms in terminal cancer patients. 1,000 ml of hydration may be used as a rough indication in terminal stage.