[Extravasation of cytostatic drugs]

Magy Onkol. 2011 Mar;55(1):4-13. Epub 2011 Mar 31.
[Article in Hungarian]

Abstract

Paravasation of cytostatic drugs during peripheral intravenous administration is a well known complication. In the United States of America it occurs in seven percent of cases with different severity and consequences. Although methods to completely avoid this complication are still unavailable, we are able to decrease the risks by identifying the patient- and procedure-related factors. The educated patient is a good indicator of paravasation in case he or she can cooperate and call the nurse. When the patient is unable to cooperate, the risks of extravasation is higher and closer nursing surveillance is indicated. The extent of injury depends mainly on the chemical structure of the extravasant substance (vesicant, irritant or non-vesicant) which may be modified by other factors. There is no strong evidence-based guidance for the management of complication. Abrupt cessation of the infusion and drawing back on the inserted venous catheter as well as elevating and resting the affected limb are necessary measures. In the available literature cooling or warming of the affected area is controversial. Similarly there are still open questions regarding the value of using antidotes as dexrazoxane, dimethylsulfoxide, thiosulfate and hyaluronidase (which is not registered as medicament in Hungary). In the event of extravasation early multidisciplinary dermatological and surgical assessment is essential for definitive diagnosis and setting the optimal management.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Antidotes / therapeutic use*
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects*
  • Catheters, Indwelling
  • Cryotherapy
  • Cytostatic Agents / administration & dosage
  • Cytostatic Agents / adverse effects*
  • Dimethyl Sulfoxide / therapeutic use
  • Extravasation of Diagnostic and Therapeutic Materials / diagnosis*
  • Extravasation of Diagnostic and Therapeutic Materials / epidemiology
  • Extravasation of Diagnostic and Therapeutic Materials / therapy*
  • Humans
  • Hungary / epidemiology
  • Hyaluronoglucosaminidase / therapeutic use
  • Infusions, Intravenous
  • Interdisciplinary Communication
  • Irritants / adverse effects
  • Razoxane / therapeutic use
  • Risk Factors
  • Skin / drug effects*
  • Thiosulfates / therapeutic use
  • United States / epidemiology

Substances

  • Antidotes
  • Antineoplastic Agents
  • Cytostatic Agents
  • Irritants
  • Thiosulfates
  • Razoxane
  • Hyaluronoglucosaminidase
  • Dimethyl Sulfoxide