Incidence, risk factors and treatment outcomes of drug extravasation in pediatric patients in China

Incidence, risk factors and treatment outcomes of drug extravasation in pediatric patients in China

Extravasation injury is a common phenomenon in hospitals. Failure to detectand treat extravasation injury can lead to irreversible local injuries, tissuenecrosis and malfunction of the affected tissue. Until now, it is largely unknownabout incidence, risk factors and treatment outcomes of extravasation inChinese pediatric patients. The aim of this study is to explore the incidence,risk factors and summarize the characteristics and treatment outcomes ofextravasation injuries resulting in drug extravasation among Chinese childrenin our hospital. The children undergoing infusion therapy (0-18 years) wereenrolled in this study between December 2014 and June 2015 in ShanghaiChildren’s Hospital. The patients’ information including age, gender, injectionsite, estimated volume of solution extravasated, patient symptoms, severityof extravasation injury, treatment methods, and outcomes was collected.Multivariate logistic regression was used to identify the independent riskfactors for the development of extravasation. The incidence of extravasationsin pediatric patients was 1.79% (18/1,004). The severity of extravasation waslabeled with grade range from Grade 1 through Grade 4: 4 cases with Grade1, 8 cases with Grade 2, 5 cases with Grade 3, and 1 case with Grade 4. Therisk factors of extravasation include infused high volume/day (≥1000 ml),received operation, infused agents with high osmolarity and poor vein condition.The severity of extravasation was related to the large volumes of drug orspecial drugs (high-osmolarity, high-risk, low pH, etc). All extravasations weretreated with physical, pharmacological and surgical intervention according toour standard operation protocols. Systematic implementation of interventioncan alleviate the extravasation injuries and improve the patients’ outcome.

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  • 1. Hadaway L. Infiltration and extravasation. Am J Nurs 2007; 107: 64-72.
  • 2. Chiu K, Tindholdt TT, Tonseth KA. Extravasation injuries. Tidsskr Nor Laegeforen 2016; 136: 233-235.
  • 3. Paquette V, McGloin R, Northway T, DeZorzi P, Singh A, Carr R. Describing Intravenous Extravasation in Children (DIVE Study). Can J Hosp Pharm 2011; 64: 340-345.
  • 4. Franck LS, Hummel D, Connell K, Quinn D, Montgomery J. The safety and efficacy of peripheral intravenous catheters in ill neonates. Neonatal Netw 2001; 20: 33-38.
  • 5. Kostogloudis N, Demiri E, Tsimponis A, et al. Severe extravasation injuries in neonates: a report of 34 cases. Pediatr Dermatol 2015; 32: 830-835.
  • 6. Pluschnig U, Haslik W, Bartsch R, Mader RM. Extravasation emergencies: state-of-the-art management and progress in clinical research. Memo 2016; 9: 226- 230.
  • 7. Goon PK, Dalal M. Limb-threatening extravasation injury: topical negative pressure and limb salvage. Plast Reconstr Surg 2006; 117: 1064-1065.
  • 8. Ghanem AM, Mansour A, Exton R, et al. Childhood extravasation injuries: improved outcome following the introduction of hospital-wide guidelines. J Plast Reconstr Aesthet Surg 2015; 68: 505-518.
  • 9. Sakaida E, Sekine I, Iwasawa S, et al. Incidence, risk factors and treatment outcomes of extravasation of cytotoxic agents in an outpatient chemotherapy clinic. Jpn J Clin Oncol 2014; 44: 168-171.
  • 10. Firat C, Erbatur S, Aytekin AH. Management of extravasation injuries: a retrospective study. J Plast Surg Hand Surg 2013; 47: 60-65.
  • 11. Goutos I, Cogswell LK, Giele H. Extravasation injuries: a review. J Hand Surg Eur Vol 2014; 39: 808-818.
  • 12. Hardie AD, Kereshi B. Incidence of intravenous contrast extravasation: increased risk for patients with deep brachial catheter placement from the emergency department. Emerg Radiol 2014; 21: 235-238.
  • 13. Restieaux M, Maw A, Broadbent R, Jackson P, Barker D, Wheeler B. Neonatal extravasation injury: prevention and management in Australia and New Zealand-a survey of current practice. BMC Pediatr 2013;13: 34.
  • 14. Yan YM, Gong M, Li D, et al. Grade management in establishing pediatric peripheral venous access. Iran J Pediatr 2016; 26: e6321.
  • 15. Alami Z, Nasri S , Ahid S, Kacem HH. Extravasation of contrast medium during CT examination: an observational casecontrol study. Pan Afr Med J 2015; 20: 89.
  • 16. Gilbar PJ, Carrington CV. The incidence of extravasation of vinca alkaloids supplied in syringes or mini-bags. J Oncol Pharm Pract 2006; 12: 113-118.
  • 17. Wang CL, Cohan RH, Ellis JH, Adusumilli S, Dunnick NR. Frequency, management, and outcome of extravasation of nonionic iodinated contrast medium in 69,657 intravenous injections. Radiology 2007; 243: 80-87.
  • 18. Danski MT, Mingorance P, Johann DA, Vayego SA, Lind J. Incidence of local complications and risk factors associated with peripheral intravenous catheter in neonates. Rev Esc Enferm USP 2016; 50: 22-28.
  • 19. Kreidieh FY, Moukadem HA, El Saghir NS. Overview, prevention and management of chemotherapy extravasation. World J Clin Oncol 2016; 7: 87-97.
  • 20. Keidan I, Sidi A, Ben-Menachem E, Derazne E, Berkenstadt H. A simple diagnostic test to confirm correct intravascular placement of peripheral catheters in order to avoid extravasation. J Clin Anesth 2015; 27: 585-588.
  • 21. Schulmeister L. Extravasation Management: Clinical Update. Semin Oncol Nurs 2011; 27: 82-90.
  • 22. Bellin MF, Jakobsen JA, Tomassin I, et al. Contrast medium extravasation injury: guidelines for prevention and management. Eur Radiol 2002; 12: 2807-2812.
  • 23. Schaverien MV, Evison D, McCulley SJ. Management of large volume CT contrast medium extravasation injury: technical refinement and literature review. J Plast Reconstr Aesthet Surg 2008; 61:562-565.
  • 24. Fernández-García C, Mata-Peón E, Avanzas-Fernández S. Related factors with extravasation of non-cytostatic agents in peripheral vein catheters. Enferm Clin 2017; 27: 71-78.
  • 25. Sung KY, Lee SY. Nonoperative management of extravasation injuries associated with neonatal parenteral nutrition using multiple punctures and a hydrocolloid dressing. Wounds 2016; 28: 145-151.
  • 26. Yan YM, Fan QL, Li AQ, Chen JL, Dong FF, Gong M. Treatment of cutaneous injuries of neonates induced by drug extravasation with hyaluronidase and hirudoid. Iran J Pediatr 2014; 24:352-358.
  • 27. Coyle CE, Griffie J, Czaplewski LM. Eliminating extravasation events: A multidisciplinary approach. J Infus Nurs 2014; 37: 157-164.
Turkish Journal of Pediatrics-Cover
  • ISSN: 0041-4301
  • Yayın Aralığı: Yılda 6 Sayı
  • Başlangıç: 1958
  • Yayıncı: Hacettepe Üniversitesi Çocuk Sağlığı Enstitüsü Müdürlüğü
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