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Infusion Site Extravasation

MedGen UID:
296204
•Concept ID:
C1608954
•
Pathologic Function

Definition

Leakage of a pharmacologic or a biological substance from the infusion site into the surrounding tissue. Signs and symptoms include induration, erythema, swelling, burning sensation, and pain at the infusion site. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVInfusion Site Extravasation

Professional guidelines

PubMed

Safety and Tolerability of 23.4% Hypertonic Saline Administered Over 2 to 5 Minutes for the Treatment of Cerebral Herniation and Intracranial Pressure Elevation.
O'Brien SK, Koehl JL, Demers LB, Hayes BD, Barra ME
Neurocrit Care 2023 Apr;38(2):312-319. Epub 2022 Sep 28 doi: 10.1007/s12028-022-01604-1. PMID: 36171519
Peripheral Intravenous Access: Applying Infusion Therapy Standards of Practice to Improve Patient Safety.
Nickel B
Crit Care Nurse 2019 Feb;39(1):61-71. doi: 10.4037/ccn2019790. PMID: 30710037
Incidence, risk factors and treatment outcomes of drug extravasation in pediatric patients in China.
Yan YM, Gong M, Chen JL, Li D, Xu TT, Zou H, Li AQ, Fan QL, Lu QF
Turk J Pediatr 2017;59(2):1621-168. doi: 10.24953/turkjped.2017.02.008. PMID: 29276869

Recent clinical studies

Etiology

Peripheral Administration of Norepinephrine: A Prospective Observational Study.
Yerke JR, Mireles-Cabodevila E, Chen AY, Bass SN, Reddy AJ, Bauer SR, Kokoczka L, Dugar S, Moghekar A
Chest 2024 Feb;165(2):348-355. Epub 2023 Aug 21 doi: 10.1016/j.chest.2023.08.019. PMID: 37611862Free PMC Article
Effect of Peripherally Infused Norepinephrine on Reducing Central Venous Catheter Utilization.
Powell SM, Faust AC, George S, Townsend R, Eubank D, Kim R
J Infus Nurs 2023 Jul-Aug 01;46(4):210-216. doi: 10.1097/NAN.0000000000000508. PMID: 37406335
Safety of the Peripheral Administration of Vasopressor Agents.
Lewis T, Merchan C, Altshuler D, Papadopoulos J
J Intensive Care Med 2019 Jan;34(1):26-33. Epub 2017 Jan 11 doi: 10.1177/0885066616686035. PMID: 28073314
Extravasation injuries.
Rose RE, Felix R, Crawford-Sykes A, Venugopal R, Wharfe G, Arscott G
West Indian Med J 2008 Jan;57(1):40-7. PMID: 19565937
Oxacillin-induced tissue necrosis.
Fromm LA, Graham DL
Ann Pharmacother 1999 Oct;33(10):1060-2. doi: 10.1345/aph.18387. PMID: 10534219

Diagnosis

Monoclonal antibody extravasations: Two case reports and literature review.
Rodríguez-Alarcón A, Conde-Estévez D
J Oncol Pharm Pract 2021 Apr;27(3):761-763. Epub 2020 Aug 16 doi: 10.1177/1078155220950005. PMID: 32799778
Infusion Site Reactions: Classification in the Setting of Fosaprepitant Administration With Chemotherapy.
Segna AN, Baron RH, Cohen B
Clin J Oncol Nurs 2020 Dec 1;24(6):E79-E84. doi: 10.1188/20.CJON.E79-E84. PMID: 33216065Free PMC Article
A case of mitoxantrone extravasation.
Chang A
J Oncol Pharm Pract 2020 Jul;26(5):1270-1273. Epub 2020 Jan 6 doi: 10.1177/1078155219893736. PMID: 31902285
A systematic review of extravasation and local tissue injury from administration of vasopressors through peripheral intravenous catheters and central venous catheters.
Loubani OM, Green RS
J Crit Care 2015 Jun;30(3):653.e9-17. Epub 2015 Jan 22 doi: 10.1016/j.jcrc.2015.01.014. PMID: 25669592
Doxorubicin-associated flare reactions.
Curran CF, Luce JK, Page JA
Oncol Nurs Forum 1990 May-Jun;17(3):387-9. PMID: 2342972

Therapy

Peripheral Administration of Norepinephrine: A Prospective Observational Study.
Yerke JR, Mireles-Cabodevila E, Chen AY, Bass SN, Reddy AJ, Bauer SR, Kokoczka L, Dugar S, Moghekar A
Chest 2024 Feb;165(2):348-355. Epub 2023 Aug 21 doi: 10.1016/j.chest.2023.08.019. PMID: 37611862Free PMC Article
Safety and Tolerability of 23.4% Hypertonic Saline Administered Over 2 to 5 Minutes for the Treatment of Cerebral Herniation and Intracranial Pressure Elevation.
O'Brien SK, Koehl JL, Demers LB, Hayes BD, Barra ME
Neurocrit Care 2023 Apr;38(2):312-319. Epub 2022 Sep 28 doi: 10.1007/s12028-022-01604-1. PMID: 36171519
Safety of the Peripheral Administration of Vasopressor Agents.
Lewis T, Merchan C, Altshuler D, Papadopoulos J
J Intensive Care Med 2019 Jan;34(1):26-33. Epub 2017 Jan 11 doi: 10.1177/0885066616686035. PMID: 28073314
Development of an Evidence-Based List of Noncytotoxic Vesicant Medications and Solutions.
Gorski LA, Stranz M, Cook LS, Joseph JM, Kokotis K, Sabatino-Holmes P, Van Gosen L; Infusion Nurses Society Vesicant Task Force
J Infus Nurs 2017 Jan/Feb;40(1):26-40. doi: 10.1097/NAN.0000000000000202. PMID: 28030480
A systematic review of extravasation and local tissue injury from administration of vasopressors through peripheral intravenous catheters and central venous catheters.
Loubani OM, Green RS
J Crit Care 2015 Jun;30(3):653.e9-17. Epub 2015 Jan 22 doi: 10.1016/j.jcrc.2015.01.014. PMID: 25669592

Prognosis

Predictive Factors for Infusion Site Induration After Outpatient Chemotherapy in Japan: A Secondary Analysis.
Abe-Doi M, Murayama R, Morita K, Nakagami G, Sanada H
Asian Nurs Res (Korean Soc Nurs Sci) 2023 Dec;17(5):269-275. Epub 2023 Dec 14 doi: 10.1016/j.anr.2023.11.005. PMID: 38101470
Monoclonal antibody extravasations: Two case reports and literature review.
Rodríguez-Alarcón A, Conde-Estévez D
J Oncol Pharm Pract 2021 Apr;27(3):761-763. Epub 2020 Aug 16 doi: 10.1177/1078155220950005. PMID: 32799778
Utilization and extravasation of peripheral norepinephrine in the emergency department.
Nguyen TT, Surrey A, Barmaan B, Miller S, Oswalt A, Evans D, Dhindsa H
Am J Emerg Med 2021 Jan;39:55-59. Epub 2020 Jan 8 doi: 10.1016/j.ajem.2020.01.014. PMID: 31959524
5-Fluorouracil induced extravasation injury.
Reddy SS, Somayaji S, Krishna Murthy M, Maka VV
Indian J Cancer 2020 Oct-Dec;57(4):467-469. doi: 10.4103/ijc.IJC_281_19. PMID: 32769297
Doxorubicin-associated flare reactions.
Curran CF, Luce JK, Page JA
Oncol Nurs Forum 1990 May-Jun;17(3):387-9. PMID: 2342972

Clinical prediction guides

Peripheral Administration of Norepinephrine: A Prospective Observational Study.
Yerke JR, Mireles-Cabodevila E, Chen AY, Bass SN, Reddy AJ, Bauer SR, Kokoczka L, Dugar S, Moghekar A
Chest 2024 Feb;165(2):348-355. Epub 2023 Aug 21 doi: 10.1016/j.chest.2023.08.019. PMID: 37611862Free PMC Article
Effect of Peripherally Infused Norepinephrine on Reducing Central Venous Catheter Utilization.
Powell SM, Faust AC, George S, Townsend R, Eubank D, Kim R
J Infus Nurs 2023 Jul-Aug 01;46(4):210-216. doi: 10.1097/NAN.0000000000000508. PMID: 37406335
Safety and Tolerability of 23.4% Hypertonic Saline Administered Over 2 to 5 Minutes for the Treatment of Cerebral Herniation and Intracranial Pressure Elevation.
O'Brien SK, Koehl JL, Demers LB, Hayes BD, Barra ME
Neurocrit Care 2023 Apr;38(2):312-319. Epub 2022 Sep 28 doi: 10.1007/s12028-022-01604-1. PMID: 36171519
Monoclonal antibody extravasations: Two case reports and literature review.
Rodríguez-Alarcón A, Conde-Estévez D
J Oncol Pharm Pract 2021 Apr;27(3):761-763. Epub 2020 Aug 16 doi: 10.1177/1078155220950005. PMID: 32799778
Utilization and extravasation of peripheral norepinephrine in the emergency department.
Nguyen TT, Surrey A, Barmaan B, Miller S, Oswalt A, Evans D, Dhindsa H
Am J Emerg Med 2021 Jan;39:55-59. Epub 2020 Jan 8 doi: 10.1016/j.ajem.2020.01.014. PMID: 31959524

Recent systematic reviews

A systematic review of extravasation and local tissue injury from administration of vasopressors through peripheral intravenous catheters and central venous catheters.
Loubani OM, Green RS
J Crit Care 2015 Jun;30(3):653.e9-17. Epub 2015 Jan 22 doi: 10.1016/j.jcrc.2015.01.014. PMID: 25669592
Percutaneous central venous catheters versus peripheral cannulae for delivery of parenteral nutrition in neonates.
Ainsworth SB, Clerihew L, McGuire W
Cochrane Database Syst Rev 2004;(2):CD004219. doi: 10.1002/14651858.CD004219.pub2. PMID: 15106243

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