Hylenex-Have you used it

[RN0520]

I was at a unit meeting this morning. Our staff is going to be inserviced on Hylenex. The little info that she had is that you inject it subq though an angio cath and then you are able to give a bolus of iv fluids into that site. I have never heard of anything like this and was wondering if any of you have used it or are familiar with it. Thanks

[92RN]

We use Hylenex for sub-q infusions frequently for adults and pediatrics. It's so easy and simple. The patients and families love only one stick! It's great for patients who need hydration and discharge. We also use it to treat IV infiltrates.

[RN0520]

How does it work? What exactly do you use it for? How much fluid can you infuse? Thanks for the info

[TaraER-RN]

OK...I am super confused, I was looking at the website for this drug but can't figre out what it is....It looks like you let fluids basically infilitrate SQ instead of going intravenous, and this drug helps your body absorb it?? I can understand the rationale for then using it for an infiltrated line, but I see one poster above saying you use it for infusions? How does this work? Thanks!

[RN0520]

That is was I was thinking when I went to the website. I was confused how this worked and am trying to find out more about it.

[Pat_Pat RN]

I also have read the website, and am confused. I thought it was to facilitate SQ infusions, but the pictures show IV's in the AC's. So I don't know exactly what it is for...?!?!

[bjaeram]

I've never heard of it but you have me intrigued. I hope someone that does use it can elaborate

[Emergency RN]

hylenex is the other name for hyaluronidase, an enzyme that hydrolyzes hyaluronic acid (a ground substance in the connective tissue surrounding cells). hyaluronic acid, a polysaccharide, by its high viscosity, generally inhibits absorption of fluids and exudates from the subcutaneous tissue. by temporarily dissolving that polysaccharide with hyaluronidase, fluids or extravasated medications lodged in the subcutaneous tissue is allowed to pass this subcutaneous barrier and is therefore absorbed much more quickly.

there are two separate uses:

1. to facilitate faster absorption of extravasated medications by direct subcutaneous injection of hyaluronidase into the infiltrated area.

2. to facilitate absorption of subcutaneous infusions (a process called hypodermoclysis). the route of administration is subcutaneous, but using standard iv solutions. hypodermoclysis was an old fashion way of administering fluids before intravenous infusions became routine. it may seem rather counterintuitive to purposely infiltrate iv fluids into a patient's subcutaneous tissue, but you can literally give up to 3 liters per day in this manner. for elderly who had poor po intake or those with poor venous access, hypodermoclysis remains an old but functional clinical option worth exploring.

sources:

http://www.aafp.org/afp/20011101/1575.html

http://www4.wiwiss.fu-berlin.de/dailymed/page/drugs/2272

and precautions directly from the above site:

"discontinue hylenex recombinant (hyaluronidase human injection) if sensitization occurs. hyaluronidase should not be used to enhance the absorption and dispersion of dopamine and/or alpha agonist drugs. hyaluronidase should not be injected into or around an infected or acutely inflamed area because of the danger of spreading a localized infection. hyaluronidase should not be used to reduce the swelling of bites or stings. hyaluronidase should not be applied directly to the cornea. hyaluronidase should not be used for intravenous injections because the enzyme is rapidly inactivated"