[Introduction of a clinical protocol for extravasation at the National Institute of Oncology, Budapest, Hungary]

Magy Onkol. 2011 Mar;55(1):14-20. Epub 2011 Mar 31.
[Article in Hungarian]

Abstract

Extravasation of cytostatics occurs when an infusion containing a cytotoxic drug leaks into the surrounding perivascular and subcutaneous tissues. Incidence of cytostatic extravasation is found to be 0.1-6% according to the literature. Depending on the severity of complications, pain, loss of function in the extremities, or in extreme cases tissue necrosis necessitating an amputation may develop, drawing consequences like delay or interruption of the chemotherapy. Extent of complications is greatly influenced by the type of medication administered, general condition of the patient, and professional preparedness of staff providing the oncological health service. The protocol recently implemented in the National Institute of Oncology is a short, compact guidance for physicians and nurses providing oncological care, so by quick and adequate management of extravasation cases, severe complications could be prevented. More complex practical guidelines including algorithms could be created as a result of a wider collaboration, with the help of which oncological health professionals could easily cope with this rare problem. The authors describe in their review the implementation of the use of dry warm and cold packs, dymethylsulfoxide and hyaluronidase and their function within the algorithm of extravasation treatment.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Antidotes / therapeutic use
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects*
  • Cancer Care Facilities / organization & administration*
  • Cancer Care Facilities / standards
  • Cancer Care Facilities / trends
  • Clinical Protocols*
  • Cryotherapy
  • Cytostatic Agents / administration & dosage
  • Cytostatic Agents / adverse effects*
  • Decision Trees
  • Dimethyl Sulfoxide / therapeutic use
  • Extravasation of Diagnostic and Therapeutic Materials / diagnosis*
  • Extravasation of Diagnostic and Therapeutic Materials / drug therapy
  • Extravasation of Diagnostic and Therapeutic Materials / nursing
  • Extravasation of Diagnostic and Therapeutic Materials / surgery
  • Extravasation of Diagnostic and Therapeutic Materials / therapy*
  • Hot Temperature / therapeutic use
  • Humans
  • Hungary
  • Hyaluronoglucosaminidase / therapeutic use
  • Infusions, Intravenous / adverse effects
  • Risk Factors
  • Skin / drug effects*

Substances

  • Antidotes
  • Antineoplastic Agents
  • Cytostatic Agents
  • Hyaluronoglucosaminidase
  • Dimethyl Sulfoxide