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the role of Clysis is an old method of hydration going way back but with incorporating Hylenex( Enzyme which breaks down the hyaluronidase subcutaneous  network)  it has become a great option for difficult or unobtainable IV access.  The drug is no being market in the  ophthalmology and cosmetic surgery field but is available to be utilized for IV rehydration. 
 a multi-center PED study was ongoing for Hylenex as an alternative for rehydration but start due to certain issues. 

http://hylenex.com/mechanism-of-action/

there are mutli-centers that have protocols for using this agent for rehydration.

Thomas Abramo MD
Please excuse inadvertent errors due to the use of Dragon voice recognition software.
> Thanks,
> Thomas J. Abramo, M.D., FAAP, FACEP
> Professor of Pediatric and Emergency Medicine
> University of Arkansas School of Medicine
> Section Chief  Division of Pediatric Emergency Medicine
> Office 501-364 2299
> Confidentiality Notice: This information is peer review material designed to improve the quality of patient care and is privileged and confidential. This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.

________________________________________
From: Pediatric Emergency Medicine Discussion List <[log in to unmask]> on behalf of Sergey Kunkov <[log in to unmask]>
Sent: Friday, June 9, 2017 9:31 AM
To: [log in to unmask]
Subject: Clysis

Dear colleagues,

I wanted  to ask you about clysis: I know there was a discussion a few
years back about its use , but does anyone is using it on a routine basis
or , better yet, incorporated it in some kind of a protocol for difficult
IV access?

Thank you very much

Sergey Kunkov
Stony Brook

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