|
1
|
Martens E, Hritz R, Clifford C, Mullin C, Camero C, Shiu K, Chan C, del Alcazar C, DeRegis C, Donnelly L, Marker B, Purzycka K, Vickery K. A Retrospective Study of Chemotherapy-Related Extravasation Events in Dogs and Cats. J Vet Intern Med 2025; 39:e70042. [PMID: 40135393 PMCID: PMC11937848 DOI: 10.1111/jvim.70042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2024] [Revised: 02/12/2025] [Accepted: 02/21/2025] [Indexed: 03/27/2025] Open
Abstract
BACKGROUND Chemotherapy extravasation is a potentially serious complication. There is a paucity of information in the veterinary literature investigating extravasation events, treatments, and outcomes. OBJECTIVE Evaluate chemotherapy extravasation events and treatments in dogs and cats, adverse events (AEs), and overall outcomes. ANIMALS Twenty dogs and three cats were included. METHODS Retrospective, multicenter, descriptive study including dogs or cats with suspected extravasation from chemotherapy. Information obtained included: signalment, extravasation details and treatment provided, AEs graded according to VCOG-CTCAE v2 criteria, and outcome. RESULTS The most common drug extravasated was doxorubicin, followed by carboplatin. Carboplatin extravasation (n = 5) resulted in Grades III-IV AEs, all of which required surgical debridement. Doxorubicin extravasation (n = 9) resulted in Grades 0-V AEs, two of which amputation was ultimately recommended, and one of those two was euthanized instead. Extravasation of vinca alkaloids (n = 5) and rabacfosadine (n = 1) resulted in Grades II-III AEs, all managed in the outpatient setting. Mitoxantrone (n = 2) and dacarbazine (n = 1) extravasation resulted in no clinical signs associated with extravasation injury. Seventy-eight percent (18/23) cases had extravasation occur during one of the first four treatments of chemotherapy, with 30% (7/23) occurring during the first chemotherapy treatment. CONCLUSIONS AND CLINICAL IMPORTANCE Most cases (20/23) had mild to moderate or no AEs. Findings support that carboplatin should be considered a vesicant.
Collapse
Affiliation(s)
- Elise Martens
- Department of Clinical Sciences, Flint Animal Cancer CenterColorado State UniversityFort CollinsColoradoUSA
| | - Rachel Hritz
- Department of Clinical Sciences, Flint Animal Cancer CenterColorado State UniversityFort CollinsColoradoUSA
| | | | | | | | | | | | | | | | - Lindsay Donnelly
- Veterinary Medicine and Surgery Department, Veterinary Health CenterUniversity of MissouriColumbiaMissouriUSA
| | | | | | - Kathryn Vickery
- Department of Clinical Sciences, Flint Animal Cancer CenterColorado State UniversityFort CollinsColoradoUSA
| |
Collapse
|
|
2
|
Lin H, Huang X, Zhang Y, Nie C, Zhou W. Silver Sulfadiazine and Recombinant Human Epidermal Growth Factor Treatment for Neonatal Extravasation: A Case Report. Adv Neonatal Care 2025:00149525-990000000-00190. [PMID: 40300205 DOI: 10.1097/anc.0000000000001265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2025]
Abstract
BACKGROUND Neonates are at high risk of intravenous extravasation, which can cause severe tissue necrosis. However, few studies have combined silver sulfadiazine (SSD) with recombinant human epidermal growth factor (rh-EGF), which has limited application in neonatal patients, to treat extravasation. This report describes the case of a female neonate treated with SSD and rh-EGF for a skin injury caused by epinephrine extravasation. CLINICAL FINDINGS The patient (gestational age: 33 + 5 weeks) experienced extravasation during epinephrine hydrochloride infusion on the first day of hospitalization in the neonatal intensive care unit (NICU). PRIMARY DIAGNOSIS Extravasation was diagnosed 6 hours following initiation of epinephrine hydrochloride infusion, which led to specific signs, including erythema, swelling, and pain. INTERVENTIONS The patient suffered an extravasation injury in her right lower limb. Sterile puncture points were made from the edge of the leak toward the puncture center. Phentolamine was administered at the puncture site. SSD and rh-EGF were applied to the injured area and covered with Vaseline gauze. OUTCOMES After treatment, the extravasation injury in the right lower limb resolved without any debridement or noticeable signs of infection. The black and purple skin discoloration decreased gradually, achieving normalization 13 days post-injury. The patient recovered completely with no scarring and was subsequently discharged. PRACTICE RECOMMENDATIONS Patients receiving infusions with high extravasation risk should be continuously and carefully evaluated for signs of dislocation, leakage swelling, or extravasation to quickly identify and prevent further injury. Combining SSD and rh-EGF may be an alternative treatment for advanced extravasation lesions in the NICU.
Collapse
Affiliation(s)
- Huijia Lin
- Author Affiliations: National Key Clinical Specialty Construction Project/Neonatology Department, Guangdong Women and Children Hospital, Guangzhou, China (Ms Lin, Ms Huang, Dr Nie, Ms Zhou); and Neonatal Surgery Department, Guangdong Women and Children Hospital, Guangzhou, China (Ms Zhang)
| | | | | | | | | |
Collapse
|
|
3
|
Ma LY, Shan RF, Lu Y, Cong LY, Gu HY. Systematic Risk Analysis and Mitigation Strategies for Near-Miss Events in Interventional Operating Room Nursing. Risk Manag Healthc Policy 2025; 18:239-248. [PMID: 39845404 PMCID: PMC11752924 DOI: 10.2147/rmhp.s495603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2024] [Accepted: 01/04/2025] [Indexed: 01/24/2025] Open
Abstract
Purpose The aim of this study is to examine the characteristics of intraoperative nursing near-miss events in interventional operating rooms, systematically identify and analyze associated risks, and propose effective mitigation strategies. Patients and Methods A retrospective study was conducted using a specially designed survey focused on nursing near-miss events in Interventional operating rooms. Records of intraoperative near-miss events voluntarily reported by medical and nursing staff between January 2023 and March 2024 were analyzed. Grey relational analysis was used to evaluate and identify the associated risk factors. Results A total of 81 near-miss events were reported, with the majority (50%) occurring after 8 PM. These events were categorized into 6 main types: medication errors (60.49%), issues with consumables (16.05%), tubing-related incidents (8.64%), specimen handling errors (7.4%), transfer handover issues (4.93%), and patient transport problems (2.46%). Grey relational analysis identified air embolism formation during pressurized fluid administration as the highest risk event (ξ1 = 0.369). The risk factors were ranked as follows: weak coordination ability and lack of responsibility among nurses > operational interruptions > inadequate professional capability > poor communication between medical staff and nurses > equipment malfunction > frequent emergency surgeries and a fast paced working environment. Conclusion Medication administration errors are frequently encountered, with air embolisms during pressurized fluid infusion representing the most significant risk. Operational interruptions are major contributors to these errors, often influenced by the coordination skills and professional competencies of nurses. Clinically, it is crucial to enhance the identification and management of near-miss events to reduce the incidence of adverse outcomes during surgical procedures.
Collapse
Affiliation(s)
- Ling-Yu Ma
- Department of Operating Room, Affiliated Hospital 2 of Nantong University, Nantong, 226001, People’s Republic of China
| | - Rong-Fang Shan
- Department of Operating Room, Affiliated Hospital 2 of Nantong University, Nantong, 226001, People’s Republic of China
| | - Yong Lu
- Department of Operating Room, Affiliated Hospital 2 of Nantong University, Nantong, 226001, People’s Republic of China
| | - Lu-Yi Cong
- Department of Operating Room, Affiliated Hospital 2 of Nantong University, Nantong, 226001, People’s Republic of China
| | - Hai-Yan Gu
- Department of Nursing, Affiliated Hospital 2 of Nantong University, Nantong, 226001, People’s Republic of China
| |
Collapse
|
|
4
|
Garcia KJ, Theismann JT, Schneider TD, LeComte RS, Jarmolowicz DP, Johnson MA. Doxorubicin treatment has a biphasic effect over time on dopamine release and impulsive behavior in Wistar rats. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2025:10.1007/s00210-024-03766-5. [PMID: 39820646 DOI: 10.1007/s00210-024-03766-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2024] [Accepted: 12/24/2024] [Indexed: 01/19/2025]
Abstract
Doxorubicin (Dox) is a chemotherapy agent commonly used to treat multiple types of cancers and is associated with cognitive impairment. The goal of this work was to determine the effect of Dox treatment on dopamine release and uptake and behavior in rats. Rats received one dose per week of Dox (2.5 mg/kg, I.V.) and were sacrificed after two or four weeks. Dopamine release and uptake was measured in brain slices with fast-scan cyclic voltammetry (FSCV). A set of rats that received treatment also underwent behavioral testing with the 5-choice serial reaction timed task (5CSRTT) to measure degree of impulsiveness and attention throughout the course of treatment. Dopamine release and uptake increased substantially after treatment with Dox for two weeks compared to controls. After four weeks of treatment, release levels decreased to less than controls while there were no differences in uptake. Treatment of brain slices with pramipexole revealed that dopamine release was equally sensitive to autoregulation after two weeks of Dox treatment, but less sensitive after four weeks. Measurements from the 5CSRTT indicated that, while Dox did not affect attention, it increased impulsiveness after two and three weeks of treatment, but not after four weeks. Treatment with Dox for a short time may elevate dopamine system activity and increase impulsiveness, while longer administration then leads to an underactive dopamine system. To our knowledge this work demonstrates for the first time that Dox can have a biphasic neurochemical and behavioral effect.
Collapse
Affiliation(s)
- Kiersten J Garcia
- Ralph N. Adams Institute for Bioanalytical Chemistry, Lawrence, KS, 66047, USA
- Chemistry Department, University of Kansas, Lawrence, KS, 66045, USA
| | - Jacob T Theismann
- Ralph N. Adams Institute for Bioanalytical Chemistry, Lawrence, KS, 66047, USA
- Chemistry Department, University of Kansas, Lawrence, KS, 66045, USA
| | - Tadd D Schneider
- Department of Applied Behavioral Science, University of Kansas, Lawrence, KS, 66045, USA
| | - Robert S LeComte
- Department of Applied Behavioral Science, University of Kansas, Lawrence, KS, 66045, USA
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21224, USA
| | - David P Jarmolowicz
- Department of Applied Behavioral Science, University of Kansas, Lawrence, KS, 66045, USA
| | - Michael A Johnson
- Ralph N. Adams Institute for Bioanalytical Chemistry, Lawrence, KS, 66047, USA.
- Chemistry Department, University of Kansas, Lawrence, KS, 66045, USA.
| |
Collapse
|
|
5
|
Vasquez MP, Daly M, Boyd CJ, Crandell DE, Hall KE, Mays EL, Ngwenyama T, Ortolani J, Smith MR, Hoehne SN, Martin L, Davidow EB. Multicenter retrospective evaluation of norepinephrine extravasation in dogs and cats (2015-2021): 14 cases. J Vet Emerg Crit Care (San Antonio) 2025; 35:73-80. [PMID: 39957707 DOI: 10.1111/vec.13442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 10/27/2023] [Accepted: 11/04/2023] [Indexed: 02/18/2025]
Abstract
OBJECTIVE To document clinical complications and intervention options associated with norepinephrine (NE) extravasation in dogs and cats. DESIGN Cases were identified between 2015 and 2021. Because this is an uncommon complication, the findings are compiled as a descriptive retrospective study. SETTING Cases were provided from 4 universities and 2 private practice groups in the United States, Canada, and Australia. ANIMALS Fourteen patients (13 dogs, 1 cat) that experienced extravasation events (16 total). INTERVENTIONS Small animal patients were included where extravasation of a NE constant rate infusion (CRI) was documented. Records were reviewed for information, including suspected underlying condition, description of the interventions pursued after identification of extravasation, clinical signs after extravasation, and survival to discharge or reason for patient death or euthanasia. When available, information was collected pertaining to the NE dose, dilution, total duration of CRI, and duration of CRI before extravasation was recognized. MEASUREMENTS AND MAIN RESULTS The most commonly reported clinical signs after extravasation of NE were skin necrosis (n = 9 [64.3%]) and swelling (n = 6 [42.9%]). In 10 of 16 events (62.5%), discontinuation of the NE CRI and/or application of a warm compress to the extravasation site were performed; these were the most common nonpharmacological rescue measures. Two patients received subcutaneous phentolamine, and 1 patient underwent hyperbaric oxygen therapy. While surgical intervention was recommended for 4 dogs, 2 improved without surgical debridement. The overall survival rate from underlying disease processes was 57% (n = 8), with only 1 patient (7%) euthanized due to an injury from the extravasation. CONCLUSIONS Severe lesions can result from NE extravasation in dogs and cats, leading to euthanasia. Although phentolamine remains the treatment of choice, lesions may heal with alternative supportive measures.
Collapse
Affiliation(s)
- Maria P Vasquez
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington, USA
| | | | - Corrin J Boyd
- School of Veterinary Medicine, Murdoch University, Murdoch, Western Australia, Australia
| | | | - Kelly E Hall
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Erin Long Mays
- Department of Veterinary Clinical Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Tandi Ngwenyama
- Oregon State University Veterinary Teaching Hospital, Corvallis, Oregon, USA
| | - Jennifer Ortolani
- VCA SouthPaws Veterinary Specialists and Emergency Center, Fairfax, Virginia, USA
| | - M Ryan Smith
- Department of Veterinary Clinical Sciences, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Sabrina N Hoehne
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington, USA
| | - Linda Martin
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington, USA
| | - Elizabeth B Davidow
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington, USA
| |
Collapse
|
|
6
|
Nguyen LN, Takashima M, Cunninghame J, August D, Ullman A. Extravasation Identification and Management in Neonates and Pediatrics: A Cross Sectional Survey. Hosp Pediatr 2024; 14:1026-1034. [PMID: 39533873 DOI: 10.1542/hpeds.2023-007698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 08/06/2024] [Accepted: 08/13/2024] [Indexed: 11/16/2024]
Abstract
OBJECTIVE To explore current practice and guidelines surrounding the identification and management of extravasation injuries in Australian and New Zealand neonatal and pediatric settings. METHODS Between February and September 2023, an internet-based descriptive cross-sectional survey was distributed to Australian and New Zealand neonatal and pediatric clinicians using exponential nondiscriminative snowball sampling. Survey data domains included demographics, extravasation identification, management, local guidelines, and resources. RESULTS Of the 141 responses, the majority of respondents were registered nurses (n = 96, 68.1%), with greater than 20 years of experience (n = 51, 36.2%). Over two-thirds of respondents had no extravasation identification and management training (n = 98, 69.5%). Half of the respondents (n = 70, 49.6%) reported that increased presentation of risk factors did not alter monitoring frequency. Extravasations were primarily associated with the hand and wrist region (n = 118, 43.7%). Maintenance fluids, antibiotics and parenteral nutrition accounted for extravasation events. Acute management practices (immediate cessation of infusion) showed consistency (n = 124, 87.9%), whereas varying degrees of adoption were observed for aspirating the residual fluid. The majority of respondents (n = 119, 84%) reported the absence of a formal grading scale for extravasation severity. CONCLUSIONS Clinicians reported challenges and inconsistencies in neonatal and pediatric extravasation injury identification and management. This underscores the need for effective monitoring and identification, standardized management practices, and education to minimize the burdens of extravasation for patients, families, and the health care system.
Collapse
Affiliation(s)
- Linda N Nguyen
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia
| | - Mari Takashima
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia
- Centre for Children's Health Research, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - Jacqueline Cunninghame
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia
| | - Deanne August
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia
- Centre for Children's Health Research, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - Amanda Ullman
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia
- Centre for Children's Health Research, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| |
Collapse
|
|
7
|
Almeida CF, Carvalho S, Sarmento A, Amaral S, Borges L. Addressing Venous Extravasation, a Concern in Intravenous Iron Administration. Cureus 2024; 16:e75323. [PMID: 39776734 PMCID: PMC11706304 DOI: 10.7759/cureus.75323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2024] [Indexed: 01/11/2025] Open
Abstract
Intravenous iron is commonly used to treat anemia related to chronic illnesses, but venous extravasation, an uncommon side effect of intravenous iron, can result in persistent skin discoloration. This report presents the case of a female patient who experienced venous extravasation following intravenous iron administration, with data collected from her patient record. Although venous extravasation is a rare adverse effect, it is important for both patients and healthcare providers to recognize this potential complication. Adhering to established criteria to minimize the occurrence of extravasation and its associated risks is essential for improving patient outcomes.
Collapse
Affiliation(s)
- Catarina F Almeida
- Immunohemotherapy Department, Unidade de Saúde Local da Região de Aveiro, Aveiro, PRT
| | - Soraia Carvalho
- Immunohemotherapy Department, Unidade de Saúde Local da Região de Aveiro, Aveiro, PRT
| | - Alexandre Sarmento
- Immunohemotherapy Department, Unidade de Saúde Local da Região de Aveiro, Aveiro, PRT
| | - Sílvia Amaral
- Immunohemotherapy Department, Unidade de Saúde Local da Região de Aveiro, Aveiro, PRT
| | - Lúcia Borges
- Immunohemotherapy Department, Unidade de Saúde Local da Região de Aveiro, Aveiro, PRT
| |
Collapse
|
|
8
|
Kido K, Beavers CJ, Dulnuan K, Fida N, Guglin M, Ilonze OJ, Mentz RJ, Narang N, Rajagopalan N, Ramu B, Sattar Y, Sokos G, Jankowska EA. Management of Iron Deficiency in Heart Failure: Practical Considerations and Implementation of Evidence-Based Iron Supplementation. JACC. HEART FAILURE 2024; 12:1961-1978. [PMID: 39001744 DOI: 10.1016/j.jchf.2024.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/08/2024] [Accepted: 05/15/2024] [Indexed: 07/15/2024]
Abstract
Iron deficiency (ID) is present in approximately 50% of patients with heart failure (HF) and even higher prevalence rate up to 80% in post-acute HF setting. The current guidelines for HF recommend intravenous (IV) iron replacement in HF with reduced or mildly reduced ejection fraction and ID based on clinical trials showing improvements in quality of life and exercise capacity, and an overall treatment benefit for recurrent HF hospitalization. However, several barriers cause challenges in implementing IV iron supplementation in practice due, in part, to clinician knowledge gaps and limited resource availability to protocolize routine utilization in appropriate patients. Thus, the current review will discuss practical considerations in ID treatment, implementation of evidence-based ID treatment to improve regional health disparities with toolkits, inclusion/exclusion criteria of IV iron supplementation, and clinical controversies in ID treatment, as well as gaps in evidence and questions to be answered.
Collapse
Affiliation(s)
- Kazuhiko Kido
- West Virginia University School of Pharmacy, Morgantown, West Virginia, USA.
| | - Craig J Beavers
- University of Kentucky College of Pharmacy, Lexington, Kentucky, USA
| | - Kenneth Dulnuan
- Robert Wood Johnson University Hospital, New Brunswick, New Jersey, USA
| | | | - Maya Guglin
- Krannert Cardiovascular Research Center, Indiana University Health School of Medicine, Indianapolis, Indiana, USA
| | - Onyedika J Ilonze
- Division of Cardiovascular Medicine, Krannert Cardiovascular Research Center, Indiana University, Indianapolis, Indiana, USA
| | - Robert J Mentz
- Duke University School of Medicine, Durham, North Carolina, USA
| | - Nikhil Narang
- Advocate Heart Institute, Oak Lawn, Illinois, USA; Division of Cardiology, Department of Medicine, University of Illinois-Chicago, Chicago, Illinois, USA
| | - Navin Rajagopalan
- Division of Cardiology, University of Kentucky, Lexington, Kentucky, USA
| | | | - Yasar Sattar
- West Virginia University Medicine, Morgantown, West Virginia, USA
| | - George Sokos
- West Virginia University Medicine, Morgantown, West Virginia, USA
| | | |
Collapse
|
|
9
|
Barton A. Addressing and mitigating the high costs of extravasation and infiltration to patients and healthcare organisations. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:S4-S14. [PMID: 39585230 DOI: 10.12968/bjon.2024.0270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2024]
Abstract
Infiltration and extravasation injuries are a common complication of intravenous therapy and vascular access practice. However, there remains a lack of awareness and understanding surrounding these injuries. The first of two articles (Barton, 2024) reported on data from a study showing that the use of ivWatch infusion site surveillance technology can dramatically reduce the number of infiltration and extravasation injures with peripheral intravenous infusions of vesicant preparations, which can improve patient safety and have a positive financial impact. This second of two articles on infiltration and extravasation examines the financial and academic burdens.
Collapse
Affiliation(s)
- Andrew Barton
- Nurse Consultant IV Therapy and Vascular Access, IVAS Lead Nurse, National Infusion and Vascular Access Society (NIVAS) Chair, and WoCoVA Global Committee Member
| |
Collapse
|
|
10
|
Matsumoto K, Ryushima Y, Sato J, Aizawa Y, Aoyama T, Akaishi Y, Okamoto R, Sato Y, Sugano K, Tazumi K, Tsuji M, Fujikawa N, Bun S, Yagasaki K. Extravasation associated with cancer drug therapy: multidisciplinary guideline of the Japanese Society of Cancer Nursing, Japanese Society of Medical Oncology, and Japanese Society of Pharmaceutical Oncology. ESMO Open 2024; 9:103932. [PMID: 39389005 PMCID: PMC11490930 DOI: 10.1016/j.esmoop.2024.103932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 09/08/2024] [Accepted: 09/09/2024] [Indexed: 10/12/2024] Open
Abstract
BACKGROUND Extravasation (EV), or the leakage of anticancer drugs into perivascular and subcutaneous tissues during intravenous administration, can cause serious conditions that may require surgical intervention. Therefore, updated guidelines for EV based on systematic review are needed. Additionally, classifications for anticancer drugs that cause EV are not standardized across the current guidelines, and some novel drugs have not been classified. Therefore, this study aimed to formulate guidelines using evidence-based information for shared decision making on prevention, early detection, treatment, and care for EV in Japan and provide additional classification for tissue injury based on systematic review. MATERIALS AND METHODS The members of the Japanese Society of Cancer Nursing (JSCN), Japanese Society of Medical Oncology (JSMO), and Japanese Society of Pharmaceutical Oncology (JASPO) were surveyed about significant clinical challenges related to EV, and 17 clinical questions (CQs) were formulated. PubMed and ICHUSHI Web were searched using the Patient, Intervention, Comparison, and Outcomes terms listed in each CQ as key words. For the classification of new drugs, articles published through February 2021 were selected using the search terms 'extravasation', 'injection-site reaction', 'adverse events', and the names of individual drugs as key words. RESULTS Recommendations based on the results of randomized controlled trials (RCTs) were made with regard to the selection of central venous (CV) devices (CQ2, CQ3a, CQ3b, and CQ3c), regular replacement of peripheral venous catheters (CQ5), and use of fosaprepitant (CQ7). These CQs are novel and were not mentioned in previous guidelines. Warm compression monotherapy (CQ10b) and local injection of steroids (CQ12) are discouraged for the management of EV. Ten new drugs were classified for EV tissue injury. CONCLUSIONS This study provides updated guidelines for the prevention and treatment of EV, which can be used to help health care providers and patients and their families practice better EV management.
Collapse
Affiliation(s)
- K Matsumoto
- Medical Oncology Division, Hyogo Cancer Center, Akashi.
| | - Y Ryushima
- Department of Pharmacy, National Cancer Center Hospital East, Kashiwa
| | - J Sato
- Faculty of Pharmaceutical Sciences, Shonan University of Medical Sciences, Yokohama
| | - Y Aizawa
- Department of Pharmacy, National Defense Medical College Hospital, Tokorozawa
| | - T Aoyama
- Department of Pharmacy, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo
| | - Y Akaishi
- Medical Oncology Division, Osaka City General Hospital, Osaka
| | - R Okamoto
- Department of Medical Oncology, Chibanishi General Hospital, Matsudo
| | - Y Sato
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka
| | - K Sugano
- Kobe Training Center, Japanese Nursing Association, Kobe
| | - K Tazumi
- Oncology Center, Osaka University Hospital, Osaka
| | - M Tsuji
- Asahi Pharmacy, Ain Pharmaciez Inc., Tokyo
| | - N Fujikawa
- Department of Nursing, Ishikawa Prefectural Central Hospital, Kanazawa
| | - S Bun
- Medical Economics Division, Health Insurance Bureau, Ministry of Health, Labor and Welfare, Tokyo
| | - K Yagasaki
- Faculty of Nursing and Medical Care, Keio University, Tokyo, Japan
| |
Collapse
|
|
11
|
Wu C, Jin Z, Yang Y. A large forearm subcutaneous hematoma after contrast extravasation requires surgical managements: A case report. Medicine (Baltimore) 2024; 103:e39536. [PMID: 39252279 PMCID: PMC11383493 DOI: 10.1097/md.0000000000039536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 08/12/2024] [Indexed: 09/11/2024] Open
Abstract
RATIONALE Large extremity hematoma can rarely happen after contrast extravasation during a contrast-enhanced computed tomography scan. Some hematomas need prompt surgical managements. PATIENT CONCERNS A 77-year-old man had acute ischemic stroke and received the thrombolytic and antiplatelet therapies. He had a contrast extravasation during the computed tomography scan and developed a large hematoma in the right forearm, despite without evidence of compartment syndrome. DIAGNOSIS Right forearm hematoma, status post contrast extravasation. INTERVENTIONS The patient responded poorly to the routine care with arm elevation, cold pack, and wet dressing, and was finally treated by the surgical debridement, vacuum sealing drainage, fascioplasty, and skin flap repair. OUTCOMES Right forearm wound healed with a scar. LESSONS Large extremity hematoma can happen after contrast extravasation during computed tomography scan, which may require surgical treatments. Careful preparation, close monitor, and prompt managements should be applied in high-risk patients.
Collapse
Affiliation(s)
- Chunqiao Wu
- Department of Radiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhexia Jin
- Department of Radiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yongmei Yang
- Department of Radiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| |
Collapse
|
|
12
|
Jing Y, Jia W, Li P, Song C. Tissue Necrosis Following Extravasation of Human Immunoglobulin in an Infant. Clin Pediatr (Phila) 2024; 63:1038-1040. [PMID: 37903078 DOI: 10.1177/00099228231209688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Affiliation(s)
- Yu Jing
- Henan Children's Hospital, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Wanyu Jia
- Henan Children's Hospital, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Peng Li
- Henan Children's Hospital, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Chunlan Song
- Henan Children's Hospital, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| |
Collapse
|
|
13
|
Duggan C, Carr PJ, Gavin N, Walsh S, Simpkin A, Byrnes J, Ruhlmann CH, Chan RJ, Hernon O. Vascular access devices for prolonged intravenous therapy regimens in people diagnosed with cancer. Cochrane Database Syst Rev 2024; 8:CD015667. [PMID: 39212165 PMCID: PMC11363217 DOI: 10.1002/14651858.cd015667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
OBJECTIVES This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the relative effectiveness and vascular access device (VAD)-related complications of VADs in people requiring prolonged systemic anti-cancer treatment.
Collapse
Affiliation(s)
- Caitriona Duggan
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
- Oncology Department, Portiuncula University Hospital, Galway, Ireland
| | - Peter J Carr
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | - Nicole Gavin
- Royal Brisbane and Women's Hospital, NHMRC Centre of Research Excellence in Nursing, Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Stewart Walsh
- Discipline of Surgery, Lambe Institute, Galway, Ireland
| | - Andrew Simpkin
- School of Mathematics, Statistics and Applied Mathematics, University of Galway, Galway , Ireland
| | - Joshua Byrnes
- Centre for Applied Health economics, Griffith University, Queensland, Australia
| | - Christina H Ruhlmann
- Department of Oncology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Raymond J Chan
- School of Nursing, Queensland University of Technology, Brisbane, Australia
| | - Orlaith Hernon
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| |
Collapse
|
|
14
|
Agno KC, Yang K, Byun SH, Oh S, Lee S, Kim H, Kim K, Cho S, Jeong WI, Jeong JW. A temperature-responsive intravenous needle that irreversibly softens on insertion. Nat Biomed Eng 2024; 8:963-976. [PMID: 37903901 DOI: 10.1038/s41551-023-01116-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 09/26/2023] [Indexed: 11/01/2023]
Abstract
The high stiffness of intravenous needles can cause tissue injury and increase the risk of transmission of blood-borne pathogens through accidental needlesticks. Here we describe the development and performance of an intravenous needle whose stiffness and shape depend on body temperature. The needle is sufficiently stiff for insertion into soft tissue yet becomes irreversibly flexible after insertion, adapting to the shape of the blood vessel and reducing the risk of needlestick injury on removal, as we show in vein phantoms and ex vivo porcine tissue. In mice, the needles had similar fluid-delivery performance and caused substantially less inflammation than commercial devices for intravenous access of similar size. We also show that an intravenous needle integrated with a thin-film temperature sensor can monitor core body temperature in mice and detect fluid leakage in porcine tissue ex vivo. Temperature-responsive intravenous needles may improve patient care.
Collapse
Affiliation(s)
- Karen-Christian Agno
- School of Electrical Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | - Keungmo Yang
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sang-Hyuk Byun
- School of Electrical Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | - Subin Oh
- School of Electrical Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | - Simok Lee
- School of Electrical Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | - Heesoo Kim
- School of Electrical Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | - Kyurae Kim
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | - Sungwoo Cho
- School of Electrical Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | - Won-Il Jeong
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea.
| | - Jae-Woong Jeong
- School of Electrical Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea.
- KAIST Institute for Health Science and Technology, Daejeon, Republic of Korea.
| |
Collapse
|
|
15
|
Sblendorio E, Dentamaro V, Lo Cascio A, Germini F, Piredda M, Cicolini G. Integrating human expertise & automated methods for a dynamic and multi-parametric evaluation of large language models' feasibility in clinical decision-making. Int J Med Inform 2024; 188:105501. [PMID: 38810498 DOI: 10.1016/j.ijmedinf.2024.105501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/09/2024] [Accepted: 05/22/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Recent enhancements in Large Language Models (LLMs) such as ChatGPT have exponentially increased user adoption. These models are accessible on mobile devices and support multimodal interactions, including conversations, code generation, and patient image uploads, broadening their utility in providing healthcare professionals with real-time support for clinical decision-making. Nevertheless, many authors have highlighted serious risks that may arise from the adoption of LLMs, principally related to safety and alignment with ethical guidelines. OBJECTIVE To address these challenges, we introduce a novel methodological approach designed to assess the specific feasibility of adopting LLMs within a healthcare area, with a focus on clinical nursing, evaluating their performance and thereby directing their choice. Emphasizing LLMs' adherence to scientific advancements, this approach prioritizes safety and care personalization, according to the "Organization for Economic Co-operation and Development" frameworks for responsible AI. Moreover, its dynamic nature is designed to adapt to future evolutions of LLMs. METHOD Through integrating advanced multidisciplinary knowledge, including Nursing Informatics, and aided by a prospective literature review, seven key domains and specific evaluation items were identified as follows:A Peer Review by experts in Nursing and AI was performed, ensuring scientific rigor and breadth of insights for an essential, reproducible, and coherent methodological approach. By means of a 7-point Likert scale, thresholds are defined in order to classify LLMs as "unusable", "usable with high caution", and "recommended" categories. Nine state of the art LLMs were evaluated using this methodology in clinical oncology nursing decision-making, producing preliminary results. Gemini Advanced, Anthropic Claude 3 and ChatGPT 4 achieved the minimum score of the State of the Art Alignment & Safety domain for classification as "recommended", being also endorsed across all domains. LLAMA 3 70B and ChatGPT 3.5 were classified as "usable with high caution." Others were classified as unusable in this domain. CONCLUSION The identification of a recommended LLM for a specific healthcare area, combined with its critical, prudent, and integrative use, can support healthcare professionals in decision-making processes.
Collapse
Affiliation(s)
- Elena Sblendorio
- Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, Piazza Giulio Cesare, 11, 70124 Bari, Italy; Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Italy
| | - Vincenzo Dentamaro
- Department of Computer Science, University of Bari "Aldo Moro", Bari, Italy. https://twitter.com/vincenzoden
| | - Alessio Lo Cascio
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Italy; La Maddalena Cancer Center, Via San Lorenzo 312, 90146 Palermo, Italy
| | - Francesco Germini
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Italy; Direttore di Distretto Sociosanitario, ASL Bari, Bari, Italy
| | - Michela Piredda
- Department of Medicine and Surgery, Research Unit Nursing Science, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Rome, Italy
| | - Giancarlo Cicolini
- Department of Innovative Technologies in Medicine & Dentistry, "G.d'Annunzio" University of Chieti - Pescara, Italy
| |
Collapse
|
|
16
|
Maezawa M, Miyasaka K, Hirofuji S, Wakabayashi W, Iwata M, Nakao S, Akase T, Iguchi K, Nakamura M. Identification of Drugs and Patient Profiles at Risk for Severe Skin Injuries Due to Extravasation: Analysis of a Spontaneous Reporting System. JOURNAL OF INFUSION NURSING 2024; 47:233-248. [PMID: 38968586 DOI: 10.1097/nan.0000000000000549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2024]
Abstract
This study aimed to identify risk factors and combinations thereof that are associated with severe skin injuries due to the extravasation of injectable drugs. A cross-sectional study using the Japanese Adverse Drug Event Report database was conducted according to the RECORD-PE checklist. Adverse event reports related to necrosis, ulcers, or erosions due to extravasation were considered "with severe skin injury," and others were considered "without severe skin injury." Approximately 255 cases "with" and 260 cases "without" severe skin injury were identified. The relationship between the incidence of severe skin injury and age, sex, drugs, and primary disease was evaluated using the χ2 test. Association rule mining was used to evaluate the correlation between each combination of factors and skin injury. Nine factors were identified as independent risk factors for severe skin injury, including age (<10 or ≥70 years), peripheral parenteral nutrition use, and mental disorders. The association rule mining results suggested that a combination of specific patient backgrounds and drug use was associated with the incidence of necrosis or ulcers. The findings of this study reiterate that nurses might consider closely observing patients with the risk factors identified in this study for the prevention and early detection of extravasation-related skin injuries.
Collapse
Affiliation(s)
- Mika Maezawa
- Author Affiliations: Laboratory of Drug Informatics, Gifu Pharmaceutical University, Gifu, Japan (Mss Maezawa, Miyasaka, Hirofuji, Mr Wakabayashi, Ms Iwata, Mr Nakao, Dr Nakamura); Kifune Pharmacy, Gifu, Japan (Ms Iwata); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao); Department of Biological Science and Nursing, Yokohama City University Graduate School of Medicine, Yokohama, Japan (Dr Akase); Laboratory of Community Pharmacy, Gifu Pharmaceutical University, Gifu, Japan (Dr Iguchi)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
- Koumi Miyasaka, BPharm, Sakiko Hirofuji, BPharm, and Wataru Wakabayashi, BPharm are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy and a doctoral student at Gifu Pharmaceutical University
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital and a doctoral student at Gifu Pharmaceutical University
- Tomoko Akase, PhD, RN, Ph, is a professor in the Department of Biological Science and Nursing at Yokohama City University
- Kazuhiro Iguchi, PhD,Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
| | - Koumi Miyasaka
- Author Affiliations: Laboratory of Drug Informatics, Gifu Pharmaceutical University, Gifu, Japan (Mss Maezawa, Miyasaka, Hirofuji, Mr Wakabayashi, Ms Iwata, Mr Nakao, Dr Nakamura); Kifune Pharmacy, Gifu, Japan (Ms Iwata); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao); Department of Biological Science and Nursing, Yokohama City University Graduate School of Medicine, Yokohama, Japan (Dr Akase); Laboratory of Community Pharmacy, Gifu Pharmaceutical University, Gifu, Japan (Dr Iguchi)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
- Koumi Miyasaka, BPharm, Sakiko Hirofuji, BPharm, and Wataru Wakabayashi, BPharm are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy and a doctoral student at Gifu Pharmaceutical University
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital and a doctoral student at Gifu Pharmaceutical University
- Tomoko Akase, PhD, RN, Ph, is a professor in the Department of Biological Science and Nursing at Yokohama City University
- Kazuhiro Iguchi, PhD,Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
| | - Sakiko Hirofuji
- Author Affiliations: Laboratory of Drug Informatics, Gifu Pharmaceutical University, Gifu, Japan (Mss Maezawa, Miyasaka, Hirofuji, Mr Wakabayashi, Ms Iwata, Mr Nakao, Dr Nakamura); Kifune Pharmacy, Gifu, Japan (Ms Iwata); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao); Department of Biological Science and Nursing, Yokohama City University Graduate School of Medicine, Yokohama, Japan (Dr Akase); Laboratory of Community Pharmacy, Gifu Pharmaceutical University, Gifu, Japan (Dr Iguchi)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
- Koumi Miyasaka, BPharm, Sakiko Hirofuji, BPharm, and Wataru Wakabayashi, BPharm are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy and a doctoral student at Gifu Pharmaceutical University
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital and a doctoral student at Gifu Pharmaceutical University
- Tomoko Akase, PhD, RN, Ph, is a professor in the Department of Biological Science and Nursing at Yokohama City University
- Kazuhiro Iguchi, PhD,Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
| | - Wataru Wakabayashi
- Author Affiliations: Laboratory of Drug Informatics, Gifu Pharmaceutical University, Gifu, Japan (Mss Maezawa, Miyasaka, Hirofuji, Mr Wakabayashi, Ms Iwata, Mr Nakao, Dr Nakamura); Kifune Pharmacy, Gifu, Japan (Ms Iwata); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao); Department of Biological Science and Nursing, Yokohama City University Graduate School of Medicine, Yokohama, Japan (Dr Akase); Laboratory of Community Pharmacy, Gifu Pharmaceutical University, Gifu, Japan (Dr Iguchi)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
- Koumi Miyasaka, BPharm, Sakiko Hirofuji, BPharm, and Wataru Wakabayashi, BPharm are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy and a doctoral student at Gifu Pharmaceutical University
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital and a doctoral student at Gifu Pharmaceutical University
- Tomoko Akase, PhD, RN, Ph, is a professor in the Department of Biological Science and Nursing at Yokohama City University
- Kazuhiro Iguchi, PhD,Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
| | - Mari Iwata
- Author Affiliations: Laboratory of Drug Informatics, Gifu Pharmaceutical University, Gifu, Japan (Mss Maezawa, Miyasaka, Hirofuji, Mr Wakabayashi, Ms Iwata, Mr Nakao, Dr Nakamura); Kifune Pharmacy, Gifu, Japan (Ms Iwata); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao); Department of Biological Science and Nursing, Yokohama City University Graduate School of Medicine, Yokohama, Japan (Dr Akase); Laboratory of Community Pharmacy, Gifu Pharmaceutical University, Gifu, Japan (Dr Iguchi)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
- Koumi Miyasaka, BPharm, Sakiko Hirofuji, BPharm, and Wataru Wakabayashi, BPharm are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy and a doctoral student at Gifu Pharmaceutical University
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital and a doctoral student at Gifu Pharmaceutical University
- Tomoko Akase, PhD, RN, Ph, is a professor in the Department of Biological Science and Nursing at Yokohama City University
- Kazuhiro Iguchi, PhD,Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
| | - Satoshi Nakao
- Author Affiliations: Laboratory of Drug Informatics, Gifu Pharmaceutical University, Gifu, Japan (Mss Maezawa, Miyasaka, Hirofuji, Mr Wakabayashi, Ms Iwata, Mr Nakao, Dr Nakamura); Kifune Pharmacy, Gifu, Japan (Ms Iwata); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao); Department of Biological Science and Nursing, Yokohama City University Graduate School of Medicine, Yokohama, Japan (Dr Akase); Laboratory of Community Pharmacy, Gifu Pharmaceutical University, Gifu, Japan (Dr Iguchi)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
- Koumi Miyasaka, BPharm, Sakiko Hirofuji, BPharm, and Wataru Wakabayashi, BPharm are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy and a doctoral student at Gifu Pharmaceutical University
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital and a doctoral student at Gifu Pharmaceutical University
- Tomoko Akase, PhD, RN, Ph, is a professor in the Department of Biological Science and Nursing at Yokohama City University
- Kazuhiro Iguchi, PhD,Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
| | - Tomoko Akase
- Author Affiliations: Laboratory of Drug Informatics, Gifu Pharmaceutical University, Gifu, Japan (Mss Maezawa, Miyasaka, Hirofuji, Mr Wakabayashi, Ms Iwata, Mr Nakao, Dr Nakamura); Kifune Pharmacy, Gifu, Japan (Ms Iwata); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao); Department of Biological Science and Nursing, Yokohama City University Graduate School of Medicine, Yokohama, Japan (Dr Akase); Laboratory of Community Pharmacy, Gifu Pharmaceutical University, Gifu, Japan (Dr Iguchi)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
- Koumi Miyasaka, BPharm, Sakiko Hirofuji, BPharm, and Wataru Wakabayashi, BPharm are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy and a doctoral student at Gifu Pharmaceutical University
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital and a doctoral student at Gifu Pharmaceutical University
- Tomoko Akase, PhD, RN, Ph, is a professor in the Department of Biological Science and Nursing at Yokohama City University
- Kazuhiro Iguchi, PhD,Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
| | - Kazuhiro Iguchi
- Author Affiliations: Laboratory of Drug Informatics, Gifu Pharmaceutical University, Gifu, Japan (Mss Maezawa, Miyasaka, Hirofuji, Mr Wakabayashi, Ms Iwata, Mr Nakao, Dr Nakamura); Kifune Pharmacy, Gifu, Japan (Ms Iwata); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao); Department of Biological Science and Nursing, Yokohama City University Graduate School of Medicine, Yokohama, Japan (Dr Akase); Laboratory of Community Pharmacy, Gifu Pharmaceutical University, Gifu, Japan (Dr Iguchi)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
- Koumi Miyasaka, BPharm, Sakiko Hirofuji, BPharm, and Wataru Wakabayashi, BPharm are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy and a doctoral student at Gifu Pharmaceutical University
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital and a doctoral student at Gifu Pharmaceutical University
- Tomoko Akase, PhD, RN, Ph, is a professor in the Department of Biological Science and Nursing at Yokohama City University
- Kazuhiro Iguchi, PhD,Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
| | - Mitsuhiro Nakamura
- Author Affiliations: Laboratory of Drug Informatics, Gifu Pharmaceutical University, Gifu, Japan (Mss Maezawa, Miyasaka, Hirofuji, Mr Wakabayashi, Ms Iwata, Mr Nakao, Dr Nakamura); Kifune Pharmacy, Gifu, Japan (Ms Iwata); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao); Department of Biological Science and Nursing, Yokohama City University Graduate School of Medicine, Yokohama, Japan (Dr Akase); Laboratory of Community Pharmacy, Gifu Pharmaceutical University, Gifu, Japan (Dr Iguchi)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
- Koumi Miyasaka, BPharm, Sakiko Hirofuji, BPharm, and Wataru Wakabayashi, BPharm are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy and a doctoral student at Gifu Pharmaceutical University
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital and a doctoral student at Gifu Pharmaceutical University
- Tomoko Akase, PhD, RN, Ph, is a professor in the Department of Biological Science and Nursing at Yokohama City University
- Kazuhiro Iguchi, PhD,Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
| |
Collapse
|
|
17
|
Munthuli A, Thepsoparn M, Pooprasert P, Phienphanich P, Pongcharoen P, Sakonlaya D, Sittiwattanawong P, Weschawalit S, Chakkavittumrong P, Thongthawee B, Pathomjaruwat T, Tantibundhit C. Redefining the Classification of Extravasation Severity Using CLIP Linear Probe with Few-shot Instances. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2024; 2024:1-4. [PMID: 40040192 DOI: 10.1109/embc53108.2024.10782522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2025]
Abstract
This study addresses extravasation, a critical issue requiring prompt detection for effective management to avoid severe complications. This work harnesses the capability of zero-shot capabilities from pre-trained vision transformer models-specifically, GroundingDINO and Segment Anything Model (SAM) for segment human skin regions, and Contrastive Language-Image Pretraining (CLIP) for extracting rich features from these regions using its frozen image encoder. Our methodology applies linear probe techniques to feature vectors obtained from CLIP using few-shot instances. The results demonstrate accurate classification of extravasation severities with training using only 64 instances per class, achieving average F1macro scores of 74.08% for GroundingDINO-CLIP. This marks an improvement result to the previous study which utilized dual U-Nets for skin and lesion segmentation alongside DenseNet-121 models for classification with training using 975 instances. Notably, this approach increases previous F1macro scores by 3.27% in mild extravasation cases. This research advances fine-grained extravasation classification, specifically in early detection, achieved through few-shot models in a unique context.
Collapse
|
|
18
|
Pham TD, Tsunoyama T. Exploring Extravasation in Cancer Patients. Cancers (Basel) 2024; 16:2308. [PMID: 39001371 PMCID: PMC11240416 DOI: 10.3390/cancers16132308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 06/17/2024] [Accepted: 06/21/2024] [Indexed: 07/16/2024] Open
Abstract
Extravasation, the unintended leakage of intravenously administered substances, poses significant challenges in cancer treatment, particularly during chemotherapy and radiotherapy. This comprehensive review explores the pathophysiology, incidence, risk factors, clinical presentation, diagnosis, prevention strategies, management approaches, complications, and long-term effects of extravasation in cancer patients. It also outlines future directions and research opportunities, including identifying gaps in the current knowledge and proposing areas for further investigation in extravasation prevention and management. Emerging technologies and therapies with the potential to improve extravasation prevention and management in both chemotherapy and radiotherapy are highlighted. Such innovations include advanced vein visualization technologies, smart catheters, targeted drug delivery systems, novel topical treatments, and artificial intelligence-based image analysis. By addressing these aspects, this review not only provides healthcare professionals with insights to enhance patient safety and optimize clinical practice but also underscores the importance of ongoing research and innovation in improving outcomes for cancer patients experiencing extravasation events.
Collapse
Affiliation(s)
- Tuan D. Pham
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AD, UK
| | | |
Collapse
|
|
19
|
Shamel S, Zarkesh MR. Acyclovir extravasation in a newborn: a case report. J Med Case Rep 2024; 18:271. [PMID: 38845030 PMCID: PMC11157697 DOI: 10.1186/s13256-024-04585-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 05/08/2024] [Indexed: 06/09/2024] Open
Abstract
OBJECTIVE Extravasation of infused drugs is not a rare problem in medical practice. Acyclovir is a vesicant and an antiviral medication commonly used for young children. In the present study, we presented a neonate with soft tissue damage due to acyclovir extravasation. CASE REPORT A female newborn (Iranian, Asian) with gestational age 37+2 weeks and breech presentation was born by Cesarean delivery from a mother with a recent history of Herpes simplex virus (HSV) infection (Yas Women's Hospital, Tehran, Iran). Intravenous administration of acyclovir was initiated through a peripheral catheter inserted on the dorsal side of the left hand. A few minutes after the second dose, the patient showed a diffused firm swelling, local discoloration, and induration in the dorsum of the hand. The peripheral catheter was removed immediately. Hyaluronidase was injected subcutaneously in five different regions around the catheterization site. Intermittent limb elevation and cold compression (for 10 minutes) were applied. Serial follow-ups and examinations were performed hourly to check limb inflammation, ischemia, and compartment syndrome. The limb swelling and discoloration significantly improved 4 hours after the second dose of hyaluronidase. CONCLUSION Early diagnosis of acyclovir extravasation and immediate management could prevent severe complications in neonates. Further studies are needed to suggest a standard approach and treatment protocol for acyclovir extravasation.
Collapse
Affiliation(s)
- Shirin Shamel
- Department of Neonatology, Yas Hospital Complex, Tehran University of Medical Sciences, Sarv Ave., North Nejatolahi Street, Tehran, 1598718311, Iran
| | - Mohammad Reza Zarkesh
- Department of Neonatology, Yas Hospital Complex, Tehran University of Medical Sciences, Sarv Ave., North Nejatolahi Street, Tehran, 1598718311, Iran.
- Maternal, Fetal, and Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
|
20
|
Iacobellis F, Di Serafino M, Russo C, Ronza R, Caruso M, Dell’Aversano Orabona G, Camillo C, Sabatino V, Grimaldi D, Rinaldo C, Barbuto L, Verde F, Giacobbe G, Schillirò ML, Scarano E, Romano L. Safe and Informed Use of Gadolinium-Based Contrast Agent in Body Magnetic Resonance Imaging: Where We Were and Where We Are. J Clin Med 2024; 13:2193. [PMID: 38673466 PMCID: PMC11051151 DOI: 10.3390/jcm13082193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 03/28/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024] Open
Abstract
Gadolinium-based contrast agents (GBCAs) have helped to improve the role of magnetic resonance imaging (MRI) for the diagnosis and treatment of diseases. There are currently nine different commercially available gadolinium-based contrast agents (GBCAs) that can be used for body MRI cases, and which are classifiable according to their structures (cyclic or linear) or biodistribution (extracellular-space agents, target/specific-agents, and blood-pool agents). The aim of this review is to illustrate the commercially available MRI contrast agents, their effect on imaging, and adverse reaction on the body, with the goal to lead to their proper selection in different clinical contexts. When we have to choose between the different GBCAs, we have to consider several factors: (1) safety and clinical impact; (2) biodistribution and diagnostic application; (3) higher relaxivity and better lesion detection; (4) higher stability and lower tissue deposit; (5) gadolinium dose/concentration and lower volume injection; (6) pulse sequences and protocol optimization; (7) higher contrast-to-noise ratio at 3.0 T than at 1.5 T. Knowing the patient's clinical information, the relevant GBCAs properties and their effect on body MRI sequences are the key features to perform efficient and high-quality MRI examination.
Collapse
Affiliation(s)
- Francesca Iacobellis
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, 80131 Naples, Italy; (M.D.S.); (M.C.); (G.D.O.); (C.C.); (V.S.); (D.G.); (C.R.); (L.B.); (F.V.); (G.G.); (M.L.S.); (L.R.)
| | - Marco Di Serafino
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, 80131 Naples, Italy; (M.D.S.); (M.C.); (G.D.O.); (C.C.); (V.S.); (D.G.); (C.R.); (L.B.); (F.V.); (G.G.); (M.L.S.); (L.R.)
| | - Camilla Russo
- Neuroradiology Unit, Department of Neuroscience Santobono-Pausilipon Children’s Hospital, 80122 Naples, Italy;
| | - Roberto Ronza
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, 80131 Naples, Italy; (M.D.S.); (M.C.); (G.D.O.); (C.C.); (V.S.); (D.G.); (C.R.); (L.B.); (F.V.); (G.G.); (M.L.S.); (L.R.)
| | - Martina Caruso
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, 80131 Naples, Italy; (M.D.S.); (M.C.); (G.D.O.); (C.C.); (V.S.); (D.G.); (C.R.); (L.B.); (F.V.); (G.G.); (M.L.S.); (L.R.)
| | - Giuseppina Dell’Aversano Orabona
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, 80131 Naples, Italy; (M.D.S.); (M.C.); (G.D.O.); (C.C.); (V.S.); (D.G.); (C.R.); (L.B.); (F.V.); (G.G.); (M.L.S.); (L.R.)
| | - Costanza Camillo
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, 80131 Naples, Italy; (M.D.S.); (M.C.); (G.D.O.); (C.C.); (V.S.); (D.G.); (C.R.); (L.B.); (F.V.); (G.G.); (M.L.S.); (L.R.)
| | - Vittorio Sabatino
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, 80131 Naples, Italy; (M.D.S.); (M.C.); (G.D.O.); (C.C.); (V.S.); (D.G.); (C.R.); (L.B.); (F.V.); (G.G.); (M.L.S.); (L.R.)
| | - Dario Grimaldi
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, 80131 Naples, Italy; (M.D.S.); (M.C.); (G.D.O.); (C.C.); (V.S.); (D.G.); (C.R.); (L.B.); (F.V.); (G.G.); (M.L.S.); (L.R.)
| | - Chiara Rinaldo
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, 80131 Naples, Italy; (M.D.S.); (M.C.); (G.D.O.); (C.C.); (V.S.); (D.G.); (C.R.); (L.B.); (F.V.); (G.G.); (M.L.S.); (L.R.)
| | - Luigi Barbuto
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, 80131 Naples, Italy; (M.D.S.); (M.C.); (G.D.O.); (C.C.); (V.S.); (D.G.); (C.R.); (L.B.); (F.V.); (G.G.); (M.L.S.); (L.R.)
| | - Francesco Verde
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, 80131 Naples, Italy; (M.D.S.); (M.C.); (G.D.O.); (C.C.); (V.S.); (D.G.); (C.R.); (L.B.); (F.V.); (G.G.); (M.L.S.); (L.R.)
| | - Giuliana Giacobbe
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, 80131 Naples, Italy; (M.D.S.); (M.C.); (G.D.O.); (C.C.); (V.S.); (D.G.); (C.R.); (L.B.); (F.V.); (G.G.); (M.L.S.); (L.R.)
| | - Maria Laura Schillirò
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, 80131 Naples, Italy; (M.D.S.); (M.C.); (G.D.O.); (C.C.); (V.S.); (D.G.); (C.R.); (L.B.); (F.V.); (G.G.); (M.L.S.); (L.R.)
| | - Enrico Scarano
- Department of Radiology, “San Carlo” Hospital, 85100 Potenza, Italy;
| | - Luigia Romano
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, 80131 Naples, Italy; (M.D.S.); (M.C.); (G.D.O.); (C.C.); (V.S.); (D.G.); (C.R.); (L.B.); (F.V.); (G.G.); (M.L.S.); (L.R.)
| |
Collapse
|
|
21
|
Barton A. Extravasation and infiltration: under-recognised complications of intravenous therapy. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:S18-S26. [PMID: 38578942 DOI: 10.12968/bjon.2024.33.7.s18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Abstract
Occasionally, the administration of intravenous (IV) therapies can go wrong. Infiltration or extravasation is a complication when a drug or IV therapy leaks into the tissues surrounding the vascular access device. Extravasation can cause serious and often life-changing injuries. Extravasation is often associated with systemic anti-cancer therapy but non-chemotherapy drugs have been reported as having a greater risk of serious complications. This study outlines the first UK Infusion unit evaluation of the ivWatch infusion monitoring device which was undertaken from August 2023 to January 2024. Out of 2254 infusions monitored with ivWatch, the device prevented 122 cases of infiltration and extravasation from causing any harm to the patient, corresponding to a 5.4% 'check IV' notification rate.
Collapse
Affiliation(s)
- Andrew Barton
- Nurse Consultant IV Therapy and Vascular Access, IVAS Lead Nurse, FHFT Product Selection Group Chair, National Infusion and Vascular Access Society (NIVAS) Chair, WoCoVA Global Committee Member
| |
Collapse
|
|
22
|
Barton A. Addressing and mitigating the high costs of extravasation and infiltration to patients and healthcare organisations. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:S13-S23. [PMID: 40359184 DOI: 10.12968/bjon.2024.33.sup7.s13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2025]
Abstract
Infiltration and extravasation injuries are a common complication of intravenous therapy and vascular access practice. However, there remains a lack of awareness and understanding surrounding these injuries. The first of two articles (Barton, 2024) reported on data from a study showing that the use of ivWatch infusion site surveillance technology can dramatically reduce the number of infiltration and extravasation injures with peripheral intravenous infusions of vesicant preparations, which can improve patient safety and have a positive financial impact. This second of two articles on infiltration and extravasation examines the financial and academic burdens.
Collapse
Affiliation(s)
- Andrew Barton
- Nurse Consultant IV Therapy and Vascular Access, IVAS Lead Nurse, National Infusion and Vascular Access Society (NIVAS) Chair, and WoCoVA Global Committee Member
| |
Collapse
|
|
23
|
Barton A. Extravasation and infiltration: under-recognised complications of intravenous therapy. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:S4-S12. [PMID: 40359185 DOI: 10.12968/bjon.2024.33.sup7.s4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2025]
Abstract
Occasionally, the administration of intravenous (IV) therapies can go wrong. Infiltration or extravasation is a complication when a drug or IV therapy leaks into the tissues surrounding the vascular access device. Extravasation can cause serious and often life-changing injuries. Extravasation is often associated with systemic anti-cancer therapy but non-chemotherapy drugs have been reported as having a greater risk of serious complications. This study outlines the first UK Infusion unit evaluation of the ivWatch infusion monitoring device which was undertaken from August 2023 to January 2024. Out of 2254 infusions monitored with ivWatch, the device prevented 122 cases of infiltration and extravasation from causing any harm to the patient, corresponding to a 5.4% 'check IV' notification rate.
Collapse
Affiliation(s)
- Andrew Barton
- Nurse Consultant IV Therapy and Vascular Access, IVAS Lead Nurse, FHFT Product Selection Group Chair, National Infusion and Vascular Access Society (NIVAS) Chair, WoCoVA Global Committee Member
| |
Collapse
|
|
24
|
Bauters T, Clottens N, Albert-Marí MA. Extravasation of monoclonal antibodies commonly used in oncology: Classification, management and the role of the pharmacist. J Oncol Pharm Pract 2024; 30:488-492. [PMID: 37226295 DOI: 10.1177/10781552231178674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
INTRODUCTION Extravasation by conventional cytotoxics has been well documented. While monoclonal antibodies are not considered to have the necrotic potential of some cytotoxic medicines, they require appropriate management in case of extravasation. However, fewer data are available on their classification and appropriate management when extravasation occurs. As monoclonal antibodies are being more commonly used in current daily oncology practice, this is an issue that cannot be ignored. METHODS A scientific literature review on PubMed was conducted. All findings were critically appraised independently by 6 clinical pharmacists in order to provide a classification according to the extravasation hazard. RESULTS A classification of non-conjugated and conjugated monoclonal antibodies according to extravasation hazard has been elaborated for different molecules frequently used in oncology. In addition, general management, in case extravasation of monoclonal antibodies occurs, has been proposed and the role of the pharmacist in the extravasation process has been described. CONCLUSION A classification of hazard extent of extravasation of monoclonal antibodies with concurrent management based on literature data and expert consensus has been elaborated. In addition, the role of the oncology pharmacist is crucial in terms of follow-up and documentation of the extravasated monoclonal antibody and management is described.
Collapse
Affiliation(s)
- Tiene Bauters
- Department of Pharmacy, Ghent University Hospital, Ghent, Belgium
| | - Nele Clottens
- Department of Pharmacy, Ghent University Hospital, Ghent, Belgium
| | - María A Albert-Marí
- Servicio de Farmacia, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| |
Collapse
|
|
25
|
Ndayambaje M, Wahnou H, Sow M, Chgari O, Habyarimana T, Karkouri M, Limami Y, Naya A, Oudghiri M. Exploring the multifaceted effects of Ammi visnaga: subchronic toxicity, antioxidant capacity, immunomodulatory, and anti-inflammatory activities. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2024; 87:150-165. [PMID: 38037686 DOI: 10.1080/15287394.2023.2289430] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
Ammi visnaga (A. visnaga) is an annual herb that has been used in traditional medicine to treat various ailments attributed to the presence of its bioactive compounds. The purpose of this study was to identify and examine the phytochemical properties of the hydroalcoholic extract of A. visnaga using in vitro and in vivo models. Our findings demonstrated that the extract contained a variety of beneficial components, including phenols, flavonoids, tannins, coumarins, saponins, khellin, and visnagin. The total polyphenolic content and total flavonoid content were 23.26 mg/GAE/g dry weight and 13.26 mg/GAE/g dry weight, respectively. In vitro tests demonstrated that the extract possessed antioxidant properties as evidenced by the ability to scavenge free radicals, including DPPH, ABTS, nitric oxide (NO), phosphomolybdate, and ferric-reducing antioxidant power (FRAP). Further, the extract was found to inhibit hydrogen peroxide (H2O2)-induced hemolysis. In a 90-d in vivo study, female Wistar rats were administered 1 g/kg of A. visnaga extract orally resulting in a significant increase in total white blood cell count. Although morphological changes were observed in the liver, no marked alterations were noted in kidneys and spleen. In a female Swiss albino mice model of acetic acid-induced vascular permeability, A. visnaga significantly inhibited extravasations of Evans blue at doses of 0.5 or 1 g/kg with inhibition percentages of 51 and 65%, respectively, blocking tissue necrosis. The extract also demonstrated potential immunomodulatory properties in mice by enhancing antibody production in response to antigens. In silico molecular docking studies demonstrated a strong affinity between khellin or visnagin and immunomodulatory proteins, NF-κB, p52, and TNF-α. These findings suggest that A. visnaga may be considered a beneficial antioxidant with immunomodulatory properties and might serve as a therapeutic agent to combat certain diseases.
Collapse
Affiliation(s)
- Martin Ndayambaje
- Laboratory of Immunology and Biodiversity, Faculty of Sciences Ain Chock, Hassan II University of Casablanca, Casablanca, Morocco
| | - Hicham Wahnou
- Laboratory of Immunology and Biodiversity, Faculty of Sciences Ain Chock, Hassan II University of Casablanca, Casablanca, Morocco
| | - Marieme Sow
- Laboratory of Immunology and Biodiversity, Faculty of Sciences Ain Chock, Hassan II University of Casablanca, Casablanca, Morocco
| | - Oumaima Chgari
- Laboratory of Immunology and Biodiversity, Faculty of Sciences Ain Chock, Hassan II University of Casablanca, Casablanca, Morocco
| | | | - Mehdi Karkouri
- Cellular and Molecular Pathology Laboratory, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Youness Limami
- Laboratory of Immunology and Biodiversity, Faculty of Sciences Ain Chock, Hassan II University of Casablanca, Casablanca, Morocco
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Abdallah Naya
- Laboratory of Immunology and Biodiversity, Faculty of Sciences Ain Chock, Hassan II University of Casablanca, Casablanca, Morocco
| | - Mounia Oudghiri
- Laboratory of Immunology and Biodiversity, Faculty of Sciences Ain Chock, Hassan II University of Casablanca, Casablanca, Morocco
| |
Collapse
|
|
26
|
Chen H, Yamane T, Haruyama T, Ishihara M, Kazahari H, Sakamoto T, Tanzawa S, Honda T, Ichikawa Y, Watanabe K, Seki N. Predictors of central line-associated bloodstream infections in cancer patients undergoing chemotherapy through implanted venous access ports: a retrospective, observational study. Transl Cancer Res 2023; 12:3538-3546. [PMID: 38192991 PMCID: PMC10774051 DOI: 10.21037/tcr-23-1217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 10/20/2023] [Indexed: 01/10/2024]
Abstract
Background Central venous catheters (CVCs) are sometimes superior to peripheral vascular access for chemotherapy. Central line-associated bloodstream infections (CLABSIs) are an important complication of CVCs in chemotherapy. Methods A retrospective, observational study was conducted to investigate patients with implanted venous access ports (PORTs) from July 2010 to June 2021 in a teaching hospital. General conditions of the PORTs, backgrounds, and characteristics of patients were compared between CLABSI cases and uninfected cases to identify predictors of CLABSI. Results A total of 566 patients with PORTs who underwent chemotherapy were enrolled in this study, with CLABSI identified in 41 patients, for a total of 436,597 catheter-days. The median duration of PORT use was 26 vs. 494 days (P<0.001) in the CLABSI and uninfected groups, respectively. There were no significant differences in tumor classification, staging, white blood cell (WBC) count, neutrophil proportion, lymphocyte proportion, albumin, C-reactive protein (CRP), and performance status between the CLABSI and uninfected groups. Multivariable analysis showed that antibiotic usage within the previous week, total protein (TP), and immediate PORT use were independently associated with CLABSI, and their odds ratios (ORs) were 4.89 [95% confidence interval (CI): 1.67, 14.35], 1.95 (95% CI: 1.14, 3.53), and 3.13 (95% CI: 1.18, 8.30), respectively. The area under the curve (AUC) of the receiver-operating characteristic curve for TP was 0.63, and the cutoff value was 5.9 g/dL. Conclusions PORT implantation should be avoided in patients who had antibiotic treatment episodes within 1 week, especially for those with low serum TP levels.
Collapse
Affiliation(s)
- Hao Chen
- Department of Oncology, Teikyo University Hospital, Tokyo, Japan
| | - Takamasa Yamane
- Department of Oncology, Teikyo University Hospital, Tokyo, Japan
| | | | - Masashi Ishihara
- Department of Oncology, Teikyo University Hospital, Tokyo, Japan
| | - Hiroki Kazahari
- Department of Oncology, Teikyo University Hospital, Tokyo, Japan
| | | | - Shigeru Tanzawa
- Department of Oncology, Teikyo University Hospital, Tokyo, Japan
| | - Takeshi Honda
- Department of Oncology, Teikyo University Hospital, Tokyo, Japan
| | - Yasuko Ichikawa
- Department of Oncology, Teikyo University Hospital, Tokyo, Japan
| | | | - Nobuhiko Seki
- Department of Oncology, Teikyo University Hospital, Tokyo, Japan
| |
Collapse
|
|
27
|
Zhu LL, Wang YH, Zhou Q. Progress in Research on the Mechanisms and Interventions of Phlebitis from the Perspective of Vascular Endothelial Cell and Signaling Pathway. J Inflamm Res 2023; 16:6469-6481. [PMID: 38170089 PMCID: PMC10759916 DOI: 10.2147/jir.s450149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 12/22/2023] [Indexed: 01/05/2024] Open
Abstract
Background Phlebitis is a common complication of intravenous administration and greatly affects clinical outcomes, patient satisfaction, and health-care expenditure. Numerous studies have revealed venous injuries only through visual and histopathological examination. Although sporadic studies have explored the cellular and molecular biological mechanisms of phlebitis and the outcomes of pharmacological interventions, an updated review over the last decade is not available. Methods Progress in research on the mechanisms and interventions of phlebitis was summarized from the perspective of endothelial cells and signaling pathways by retrieving the PubMed, Web of Science Core Collection, MEDLINE, Embase, and CNKI. Results Phlebitis involves multiple signaling pathways (eg, nuclear factor kappa B, Wnt/β-catenin, focal adhesion kinase/protein kinase B, Toll-like receptor, protein kinase C beta/NADPH oxidase, PI3K/AKT/TNF, and JAK2/STAT3), upregulation of E-selectin, GBP5/NLRP3 inflammasome axis, cell apoptosis, intracellular ROS generation, SOD reduction, stimulation of angiogenesis, and induction of autophagy-associated cell death. Preventive and curative interventions included α-solanine, baicalein, escin, intermedin, Y15, micro-ribonucleic acid-223, sotrastaurin, cimetidine, aescin, resveratrol, α-chaconine, Chahuang ointment, QingLuoTongMai, Mailuo Shutong, and N-acetylcysteine. Laboratory models included vascular endothelial cells, real-time cell-monitoring analysis, network pharmacology analysis and experimental verification in vivo, animal models of phlebitis (rat, rabbit, and mouse), rabbit models with peripherally inserted central catheters (PICC) catheterization, models of PICC/central venous catheter indwelling with combined drugs in human umbilical vein endothelial cells, and compatibility with endothelial cells. Factors affecting vascular endothelial cell injury include difference in the same class of drugs, concentration and exposure time of precipitant, and infusion strategy. Conclusion Phlebitis is accompanied by endothelial dysfunction and may involve multiple molecular and cellular mechanisms. These findings improve our understanding of the molecular targets of interventions and help identify effective candidates for the prophylaxis and treatment of phlebitis. Vascular health and risk management should be considered when initiating intravenous administration.
Collapse
Affiliation(s)
- Ling-Ling Zhu
- VIP Geriatric Ward, Division of Nursing, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of China
| | - Yan-hong Wang
- Department of Pharmacy, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of China
| | - Quan Zhou
- Department of Pharmacy, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of China
| |
Collapse
|
|
28
|
Blair WO, Ellis MA, Fada M, Wiggins AA, Wolfe RC, Patel GP, Brockhaus KK, Droege M, Ebbitt LM, Kramer B, Likar E, Petrucci K, Shah S, Taylor J, Bingham P, Krabacher S, Moon JH, Rogoz M, Jean-Jacques E, Cleary RK, Eke R, Findley R, Parrish RH. Effect of Pharmacoprophylaxis on Postoperative Outcomes in Adult Elective Colorectal Surgery: A Multi-Center Retrospective Cohort Study within an Enhanced Recovery after Surgery Framework. Healthcare (Basel) 2023; 11:3060. [PMID: 38063628 PMCID: PMC10706554 DOI: 10.3390/healthcare11233060] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 11/13/2023] [Accepted: 11/22/2023] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND The application of enhanced recovery after surgery principles decreases postoperative complications (POCs), length of stay (LOS), and readmissions. Pharmacoprophylaxis decreases morbidity, but the effect of specific regimens on clinical outcomes is unclear. METHODS AND MATERIALS Records of 476 randomly selected adult patients who underwent elective colorectal surgeries (ECRS) at 10 US hospitals were abstracted. Primary outcomes were surgical site infection (SSI), venous thromboembolism (VTE), postoperative nausea and vomiting (PONV), pain, and ileus rates. Secondary outcomes included LOS and 7- and 30-day readmission rates. RESULTS POC rates were SSI (3.4%), VTE (1.5%), PONV (47.9%), pain (58.1%), and ileus (16.1%). Cefazolin 2 g/metronidazole 500 mg and ertapenem 1 g were associated with the shortest LOS; cefotetan 2 g and cefoxitin 2 g with the longest LOS. No SSI occurred with ertapenem and cefotetan. More Caucasians than Blacks received oral antibiotics before intravenous antibiotics without impact. Enoxaparin 40 mg subcutaneously daily was the most common inpatient and discharge VTE prophylaxis. All in-hospital VTEs occurred with unfractionated heparin. Most received rescue rather than around-the-clock antiemetics. Scopolamine patches, spinal opioids, and IV lidocaine continuous infusion were associated with lower PONV. Transversus abdominis plane block with long-acting local anesthetics, celecoxib, non-anesthetic ketamine bolus, ketorolac IV, lidocaine IV, and pregabalin were associated with lower in-hospital pain severity rates. Gabapentinoids and alvimopan were associated with lower ileus rates. Acetaminophen, alvimopan, famotidine, and lidocaine patches were associated with shorter LOS. CONCLUSIONS Significant differences in pharmacotherapy regimens that may improve primary and secondary outcomes in ECRS were identified. In adult ECRS, cefotetan or ertapenem may be better regimens for preventing in-hospital SSI, while ertapenem or C/M may lead to shorter LOS. The value of OA to prevent SSI was not demonstrated. Inpatient enoxaparin, compared to UFH, may reduce VTE rates with a similar LOS. A minority of patients had a documented PONV risk assessment, and a majority used as-needed rather than around-the-clock strategies. Preoperative scopolamine patches continued postoperatively may lower PONV and PDNV severity and shorter LOS. Alvimopan may reduce ileus and shorten LOS. Anesthesia that includes TAP block, ketorolac IV, and pregabalin use may lead to reduced pain rates. Acetaminophen, alvimopan, famotidine, and lidocaine patches may shorten LOS. Given the challenges of pain management and the incidence of PONV/PDNV found in this study, additional studies should be conducted to determine optimal opioid-free anesthesia and the benefit of newer antiemetics on patient outcomes. Moreover, future research should identify latent pharmacotherapy variables that impact patient outcomes, correlate pertinent laboratory results, and examine the impact of order or care sets used for ECRS at study hospitals.
Collapse
Affiliation(s)
- William Olin Blair
- Department of Biomedical Sciences, School of Medicine, Mercer University, Columbus Campus, Columbus, GA 31902, USA; (W.O.B.); (A.A.W.); (J.H.M.); (E.J.-J.); (R.E.)
| | - Mary Allison Ellis
- Department of Pharmacy, University of Kentucky Medical Center, Lexington, KY 40536, USA; (M.A.E.); (L.M.E.)
| | - Maria Fada
- Heritage School of Osteopathic Medicine, Ohio University, Athens, OH 45701, USA;
| | - Austin Allen Wiggins
- Department of Biomedical Sciences, School of Medicine, Mercer University, Columbus Campus, Columbus, GA 31902, USA; (W.O.B.); (A.A.W.); (J.H.M.); (E.J.-J.); (R.E.)
| | - Rachel C. Wolfe
- Department of Pharmacy Services, Barnes-Jewish Hospital, St. Louis, MO 63110, USA;
| | - Gourang P. Patel
- Department of Pharmacy Services, University of Chicago Hospitals, Chicago, IL 60637, USA; (G.P.P.); (K.P.)
| | - Kara K. Brockhaus
- Department of Pharmacy Services and Surgery, Trinity Health Ann Arbor Hospital, Ann Arbor, MI 48104, USA; (K.K.B.); (R.K.C.)
| | - Molly Droege
- Department of Pharmacy Services, University of Cincinnati Medical Center, Cincinnati, OH 45219, USA; (M.D.); (P.B.); (S.K.)
| | - Laura M. Ebbitt
- Department of Pharmacy, University of Kentucky Medical Center, Lexington, KY 40536, USA; (M.A.E.); (L.M.E.)
| | - Brian Kramer
- Department of Pharmacy Services, OhioHealth/Grant Medical Center, Columbus, OH 43215, USA;
| | - Eric Likar
- Department of Pharmacy Services, West Virginia University Medicine, Morgantown, WV 26506, USA;
| | - Kerilyn Petrucci
- Department of Pharmacy Services, University of Chicago Hospitals, Chicago, IL 60637, USA; (G.P.P.); (K.P.)
| | - Sapna Shah
- Department of Pharmacy Services, Beaumont Hospital—Troy, Troy, MI 48085, USA;
| | - Jerusha Taylor
- Department of Pharmacy Services, Legacy Good Samaritan Hospital, Portland, OR 97210, USA; (J.T.); (M.R.)
| | - Paula Bingham
- Department of Pharmacy Services, University of Cincinnati Medical Center, Cincinnati, OH 45219, USA; (M.D.); (P.B.); (S.K.)
| | - Samuel Krabacher
- Department of Pharmacy Services, University of Cincinnati Medical Center, Cincinnati, OH 45219, USA; (M.D.); (P.B.); (S.K.)
| | - Jin Hyung Moon
- Department of Biomedical Sciences, School of Medicine, Mercer University, Columbus Campus, Columbus, GA 31902, USA; (W.O.B.); (A.A.W.); (J.H.M.); (E.J.-J.); (R.E.)
| | - Monica Rogoz
- Department of Pharmacy Services, Legacy Good Samaritan Hospital, Portland, OR 97210, USA; (J.T.); (M.R.)
| | - Edson Jean-Jacques
- Department of Biomedical Sciences, School of Medicine, Mercer University, Columbus Campus, Columbus, GA 31902, USA; (W.O.B.); (A.A.W.); (J.H.M.); (E.J.-J.); (R.E.)
| | - Robert K. Cleary
- Department of Pharmacy Services and Surgery, Trinity Health Ann Arbor Hospital, Ann Arbor, MI 48104, USA; (K.K.B.); (R.K.C.)
| | - Ransome Eke
- Department of Biomedical Sciences, School of Medicine, Mercer University, Columbus Campus, Columbus, GA 31902, USA; (W.O.B.); (A.A.W.); (J.H.M.); (E.J.-J.); (R.E.)
| | - Rachelle Findley
- Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada;
| | - Richard H. Parrish
- Department of Biomedical Sciences, School of Medicine, Mercer University, Columbus Campus, Columbus, GA 31902, USA; (W.O.B.); (A.A.W.); (J.H.M.); (E.J.-J.); (R.E.)
| |
Collapse
|
|
29
|
Montague T, Weaver SB, Wingate LT. Extravasation of Non-Cytotoxic Drugs in Older People. Sr Care Pharm 2023; 38:457-464. [PMID: 37885098 DOI: 10.4140/tcp.n.2023.457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Objective To describe the risk factors of extravasation, its impact on the pharmacokinetics of non-cytotoxic drugs, and management of extravasation in older individuals. Extravasation occurs when vesicants leak from blood vessels into surrounding tissue causing severe injury such as tissue necrosis while infiltration is caused by leakage of an irritant that causes injury but does not lead to tissue necrosis. Extravasation occurs in approximately 0.01% to 6% of patients, particularly with cytotoxic agents. However, there is limited documentation about extravasation of non-cytotoxic agents, particularly in older people. Data Sources A literature search of Pubmed and Medline was performed using the following search items: "extravasation," "infiltration," "elderly," and "non-cytotoxic drugs," as well as a combination of these terms. Conclusion It is important to recognize, identify, and manage extravasation early since it can have deleterious consequences for older people. It is more important to prevent extravasation than manage it using standardized evidence-based protocols, and this can be implemented in the nursing facility and acute care setting.
Collapse
|
|
30
|
Fernandes D, Santos M, Pinheiro M, Duarte H, Fontes F. Radiopharmaceutical extravasation in bone scintigraphy: a cross-sectional study. Nucl Med Commun 2023; 44:870-875. [PMID: 37464878 DOI: 10.1097/mnm.0000000000001738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
OBJETIVES Tc-99m Hydroxymethylene diphosphonate (HMDP) bone scintigraphy is commonly used to diagnose bone disorders. We aimed to quantify and characterize the occurrence of radiopharmaceutical extravasation in bone scintigraphy, using Tc-99m HMDP, as well as to compare the visual classification of the events with an independent analysis using image processing software. METHODS We conducted a cross-sectional study, using data from a total of 400 (9.1%) exams, randomly selected from all the procedures performed in 2018 in the Portuguese Institute of Oncology of Porto, Portugal. Prevalence estimate and the corresponding 95% confidence interval (CI) was computed for the presence of extravasation. Odds ratios and 95% CI were computed to quantify the association between demographic and clinical characteristics, and the occurrence of extravasation. RESULTS The prevalence of Tc-99m HMDP extravasation was 26.5% (95% CI: 22.4-31.0). Those from an inpatient setting had almost seven-fold higher odds of extravasation than those from an outpatient setting. When the wrist was used for administration, there was three times more odds of extravasation when compared to the use of hand. There were statistically significant differences in the median scores of extravasations severity obtained from image processing software according to the different grades attributed by visual appreciation ( P < 0.001). CONCLUSION Tc-99m HMDP extravasation occurred in one out of four patients, being more frequent among those from an inpatient setting and when the wrist was used for administration. Visual appreciation of the extravasation seems to be acceptable to classify its severity.
Collapse
Affiliation(s)
| | - Márcia Santos
- Imaging Department, Portuguese Oncology Institute of Porto
| | | | - Hugo Duarte
- Imaging Department, Portuguese Oncology Institute of Porto
| | - Filipa Fontes
- Oncology Nursing Research Unit, IPO Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto)
- Porto Comprehensive Cancer Centre (Porto.CCC) & RISE@CI-IPOP (Health Research Network)
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Porto, Portugal
| |
Collapse
|
|
31
|
Maezawa M, Inoue M, Satake R, Wakabayashi W, Oura K, Miyasaka K, Hirofuji S, Goto F, Iwata M, Suzuki T, Tanaka H, Horibe M, Nakao S, Tsuji T, Ieiri I, Iguchi K, Nakamura M. Profiles and Outcomes of Skin Injuries Caused by Injectable Drug Extravasation: An Analysis of the Japanese Adverse Drug Event Report Database. JOURNAL OF INFUSION NURSING 2023; 46:281-293. [PMID: 37611286 DOI: 10.1097/nan.0000000000000517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
Extravasation occurs when injectable drugs leak out of the blood vessels, damaging the surrounding tissues and causing a variety of skin injuries. This study aimed to comprehensively analyze extravasation risk, skin injury profiles, and outcomes for suspect drugs from the Japanese Adverse Drug Event Report (JADER) database. Adverse events were defined according to the Medical Dictionary for Regulatory Activities/Japanese version; the term extravasation (Standardized MedDRA Query Code: 20000136) was used in this analysis. The names of adverse events were entered as unified preferred terms and redefined to evaluate skin injury profiles. In addition, skin injury outcomes were divided into 2 broad categories: "improvement" and "no improvement." Reporting odds ratios were used to detect signals for adverse events. A total of 656 cases of extravasation-related adverse events were reported between April 2004 and January 2022. Signals for extravasation-related adverse events were detected from 11 drugs. Then, their respective skin injury profiles and outcomes were determined. These results suggest a relationship between adverse events associated with extravasation and 11 drugs and identify the characteristics of each skin injury and their outcomes. These findings will contribute to improving the quality of infusion management in clinical practice.
Collapse
Affiliation(s)
- Mika Maezawa
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Misaki Inoue
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Riko Satake
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Wataru Wakabayashi
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Keita Oura
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Koumi Miyasaka
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Sakiko Hirofuji
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Fumiya Goto
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Mari Iwata
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Takaaki Suzuki
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Hideyuki Tanaka
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Megumi Horibe
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Satoshi Nakao
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Toshikazu Tsuji
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Ichiro Ieiri
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Kazuhiro Iguchi
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| | - Mitsuhiro Nakamura
- Laboratories of Drug Informatics (Mss Maezawa, Inoue, Satake, Miyasaka, Hirofuji, and Iwata, Messrs Wakabayashi, Oura, Goto, Suzuki, Tanaka, and Nakao, and Dr Nakamura) and Community Pharmacy (Dr Iguchi), Gifu Pharmaceutical University, Gifu, Japan; Kifune Pharmacy, Gifu, Japan (Ms Iwata); Gifu Prefectural Government, Gifu, Japan (Mr Suzuki); Chubu Yakuhin Co. Ltd., Tajimi, Japan (Mr Tanaka); Department of Nursing, School of Health Science, Asahi University, Mizuho, Japan (Dr Horibe); Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan (Mr Nakao and Drs Tsuji and Ieiri)
- Mika Maezawa, MS, RN, received her bachelor's and master's degrees in nursing at Yokohama City University in Japan. After receiving her master's degree, she worked as an RN at a university hospital for 3 years. She is a doctoral student at Gifu Pharmaceutical University
- Misaki Inoue, Riko Satake, Wataru Wakabayashi, Keita Oura, Koumi Miyasaka, Sakiko Hirofuji, and Fumiya Goto are pharmacy students at Gifu Pharmaceutical University
- Mari Iwata, RPh, Ph, is a pharmacist at Kifune Pharmacy
- Takaaki Suzuki, RPh, Ph, is an employee of the Gifu Prefectural Government
- Hideyuki Tanaka, BPharm, Ph, is a pharmacist at Chubu Yakuhin
- Satoshi Nakao, BPharm, Ph, is a pharmacist at Kyushu University Hospital. They are doctoral students at Gifu Pharmaceutical University
- Megumi Horibe, PhD, RN, MW, is an associate professor of nursing courses at Asahi University
- Toshikazu Tsuji, PhD, Ph, is a vice-director of a pharmacy department at Kyushu University Hospital
- Ichiro Ieiri, PhD, Ph, is a director of a pharmacy department at Kyushu University Hospital
- Kazuhiro Iguchi, PhD, Ph, is a professor in the community pharmacy at Gifu Pharmaceutical University
- Mitsuhiro Nakamura, PhD, Ph, is a professor at the Laboratory of Drug Informatics, Gifu Pharmaceutical University
| |
Collapse
|
|
32
|
Weimer DS, Jones S, Ramadoss T, Milovanovic U, Shoja MM, Schwartz G. Compartment Syndrome Secondary to Calcium Gluconate Extravasation. Cureus 2023; 15:e42237. [PMID: 37609086 PMCID: PMC10440588 DOI: 10.7759/cureus.42237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 07/20/2023] [Indexed: 08/24/2023] Open
Abstract
This case report highlights a rare yet severe complication of calcium gluconate extravasation, namely, compartment syndrome. We present the case of an 86-year-old female who developed compartment syndrome following an extravasation of intravenously administered calcium gluconate for the management of hyperkalemia. Initially, mild erythema and edema were observed at the site of extravasation, which eventually progressed to severe pain, a reduction in the joint range of motion due to increased compartment pressure. Despite undergoing a series of fasciotomies, the patient's condition did not improve, and extensive tissue necrosis and gangrene necessitated amputation. This case emphasizes that calcium gluconate extravasation can lead to life-threatening complications, such as compartment syndrome, underscoring the critical importance of employing proper infusion techniques.
Collapse
Affiliation(s)
- Derek S Weimer
- Department of Medical Education, Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Sydney Jones
- Department of Medical Education, Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Tanya Ramadoss
- Department of Medical Education, Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Una Milovanovic
- Department of Medical Education, Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Mohammadali M Shoja
- Department of Medical Education, Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Gary Schwartz
- Department of Medical Education, Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| |
Collapse
|
|
33
|
Atay S, Üzen Cura Ş, Efil S. Nurses' knowledge and experience related to short peripheral venous catheter extravasation. J Vasc Access 2023; 24:848-853. [PMID: 34590526 DOI: 10.1177/11297298211045589] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The majority of hospitalized patients receive a Peripheral Venous Catheter (PVC) in the course of their treatment. Extravasation injury is a serious complication of intravenous treatment. OBJECTIVE This cross-sectional survey designed study aims to investigate nurses' knowledge and experience related to short peripheral venous catheter extravasation. METHOD The study sample included 145 nurses working in a university hospital in the west of Turkey. A questionnaire developed in accordance with the literature was used for data collection. The data were assessed by frequency and proportions. RESULTS Of the nurses included in this study, 26.2% reported they had experienced extravasation injury in a patient; 74.5% said they had received no instruction in the management of extravasation during their in-service training program; and 85.5% stated they did not keep a record of extravasation. 89.7% of the nurses reported infused medications as a cause of extravasation, and 81.4% reported catheter sites as a cause. Among the medications reported by the nurses as causing extravasation: 89.7% reported contrast agents; 84.8% TPN solutions; 71.0% cytotoxic agents; and 65.1% mannitol. The symptoms of extravasation reported by nurses included: swelling (97.9%), redness (97.2%), pain (92.4%), rise in temperature (65.5%), and ulceration (60.0%). In responding to the occurrence of extravasation, interventions reported by the nurses included: stopping the flow of fluid (98.6%), elevation (89.7%), cold application (76.6%), and aspiration of drug (40.7%). CONCLUSION Based on these results, it is recommended that guidelines are developed for the management of extravasation, that periodic in-service training programs are provided and that observational studies are carried out into the administration of vesicant drugs.
Collapse
Affiliation(s)
- Selma Atay
- Nursing Department at School of Health, Çanakkale Onsekiz Mart University, Canakkale, Turkey
| | - Şengül Üzen Cura
- Nursing Department at School of Health, Çanakkale Onsekiz Mart University, Canakkale, Turkey
| | - Sevda Efil
- Nursing Department at School of Health, Çanakkale Onsekiz Mart University, Canakkale, Turkey
| |
Collapse
|
|
34
|
Hirata I, Mazzotta A, Makvandi P, Cesini I, Brioschi C, Ferraris A, Mattoli V. Sensing Technologies for Extravasation Detection: A Review. ACS Sens 2023; 8:1017-1032. [PMID: 36912628 PMCID: PMC10043935 DOI: 10.1021/acssensors.2c02602] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/27/2023] [Indexed: 03/14/2023]
Abstract
Peripheral intravenous catheters are administered for various purposes, such as blood sampling or the infusion of contrast agents and drugs. Extravasation happens when the catheter is unintentionally directed outside of the vein due to movement of the intravascular catheter, enhanced vascular permeability, or occlusion of the upstream vein. In this article, extravasation and its mechanism are discussed. Subsequently, the sensorized devices (e.g., single sensor and multimodal detection) to identify the extravasation phenomena are highlighted. In this review article, we have shed light on both physiological and engineering points of view of extravasation and its detection approaches. This review provides an overview on the most recent and relevant technologies that can help in the early detection of extravasation.
Collapse
Affiliation(s)
- Ikue Hirata
- Center for
Materials Interfaces, Istituto Italiano
di Tecnologia, 56025 Pontedera, Pisa, Italy
| | - Arianna Mazzotta
- Center for
Materials Interfaces, Istituto Italiano
di Tecnologia, 56025 Pontedera, Pisa, Italy
- The
Biorobotics Institute, Scuola Superiore
Sant’Anna, Pontedera 56025, Italy
| | - Pooyan Makvandi
- Center for
Materials Interfaces, Istituto Italiano
di Tecnologia, 56025 Pontedera, Pisa, Italy
| | - Ilaria Cesini
- Center for
Materials Interfaces, Istituto Italiano
di Tecnologia, 56025 Pontedera, Pisa, Italy
| | - Chiara Brioschi
- IIT-Bracco
Joint Lab, Istituto Italiano di Tecnologia, 16163 Genova, Italy
- Bracco
S.p.A., 20134 Milano, Italy
| | - Andrea Ferraris
- IIT-Bracco
Joint Lab, Istituto Italiano di Tecnologia, 16163 Genova, Italy
- Bracco
S.p.A., 20134 Milano, Italy
| | - Virgilio Mattoli
- Center for
Materials Interfaces, Istituto Italiano
di Tecnologia, 56025 Pontedera, Pisa, Italy
| |
Collapse
|
|
35
|
Issani A. An updated narrative review on the management of the most common oncological and hematological emergencies. Dis Mon 2023; 69:101355. [PMID: 35379468 DOI: 10.1016/j.disamonth.2022.101355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Oncological emergencies are defined as an acute life-threatening event in a patient with a tumor occurring as part of their complex treatment regimen or secondarily to their underlying malignancy. These events can occur at any time from the initial diagnosis of their cancer to end-stage disease. These oncological emergencies are broadly classified into four major categories; metabolic, structural, hematological and treatment-related causes; and can be encountered in any clinical setting, ranging from primary care physician and emergency department visits to a variety of subspecialty environments. This study aims to cover an in-depth review of the underlying pathogenesis, clinical presentation, and updated management protocol of most common emergencies belonging to the above-mentioned categories. An all-language literature search was conducted on 15th October 2021 and 10th March 2022, limited to 5 years on PubMed database using the following search strings: oncological emergencies, malignant spinal cord compression, febrile neutropenia, hyperviscosity syndrome, superior vena cava syndrome, immune related adverse events, tumor lysis syndrome, hypercalcemia of malignancy, corrected calcium, malignant pericardial effusion and chemotherapy extravasation.
Collapse
Affiliation(s)
- Ali Issani
- Baqai Medical University, Karachi, Pakistan.
| |
Collapse
|
|
36
|
Billingham M, Mittal R. Peripheral venous extravasation injury. BJA Educ 2023; 23:42-45. [PMID: 36686886 PMCID: PMC9845539 DOI: 10.1016/j.bjae.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- M.J. Billingham
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - R. Mittal
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| |
Collapse
|
|
37
|
Shi R, Marin JG, Beaulieu M. Skin Staining Following Intravenous Iron Extravasation in a Patient With Chronic Kidney Disease: A Case Report. Can J Kidney Health Dis 2023; 10:20543581231165705. [PMID: 37101846 PMCID: PMC10123906 DOI: 10.1177/20543581231165705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 02/06/2023] [Indexed: 04/28/2023] Open
Abstract
Rationale Intravenous iron is commonly use in anemia related to chronic kidney disease. Skin staining due to iron extravasation is a rare adverse reaction that can leave a long-term staining of the skin. Presenting Concerns of the Patients During iron derisomaltose infusion, patient reported iron extravasation. Five months after the incident, the skin stain related to the extravasation was still present. Diagnosis A case of skin staining due to iron derisomaltose extravasation was diagnosed. Interventions/Outcomes She was reviewed by dermatology and laser therapy was offered. Teaching Points Patients and clinicians need to be aware of this complication, and protocol needs to be put in place to minimize extravasation and its complication.
Collapse
Affiliation(s)
- Ruolin Shi
- Pharmaceutical Sciences, The University of British Columbia, Vancouver, Canada
| | - Judith G. Marin
- Nephrology, St. Paul’s Hospital, Vancouver, BC, Canada
- Judith G. Marin, Nephrology, St. Paul’s Hospital, 608-1125 Howe Street, Vancouver, BC V6Z 2K8, Canada.
| | | |
Collapse
|
|
38
|
Freitas KABDS, Minicucci EM, da Silva VFB, Menozzi BD, Langoni H, Popim RC. Effects of photobiomodulation (660 nm laser) on anthracycline extravasation: An experimental study. Rev Lat Am Enfermagem 2022; 30:e3693. [PMID: 36287401 PMCID: PMC9580991 DOI: 10.1590/1518-8345.5786.3693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 06/17/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE to investigate the effect of using different agents (topical hyaluronidase, photobiomodulation, and the association of photobiomodulation with topical hyaluronidase) in preventing the formation of lesions caused by doxorubicin extravasation, as well as in the reduction of lesions formed by extravasation of this drug. METHOD a quasi-experimental study conducted with 60 Wistar rats, randomized into four groups with 15 animals each. Group 1 (Control); Group 2 (Hyaluronidase); Group 3 (Photobiomodulation); and Group 4 (Hyaluronidase + Photobiomodulation). A wound was induced by applying 1 mg of doxorubicin to the subcutaneous tissue of the back of the animals. The concentration of topical hyaluronidase was 65 turbidity units/g and the energy employed was 1 joule of 100 mW red laser per square centimeter. With macroscopic evaluation every two days for 28 days, the following variables were observed: skin integrity, presence of blisters, hyperemia, exudate, bleeding, edema, crust, peeling and granulation tissue. RESULTS the animals from the groups subjected to photobiomodulation obtained better results in the assessment of the following variables: bleeding, hyperemia, exudate, intact skin and edema. CONCLUSION it was evidenced that the association of photobiomodulation with topical hyaluronidase was effective in reducing the local effects and assisted in the wound healing process, and that PBM alone was able to prevent appearance of lesions.
Collapse
Affiliation(s)
| | - Eliana Maria Minicucci
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Faculdade de Medicina de Botucatu, Departamento de Enfermagem, Botucatu, SP, Brazil
| | | | - Benedito Donizete Menozzi
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Faculdade de Medicina Veterinária e Zootecnia de Botucatu, Botucatu, SP, Brazil
| | - Hélio Langoni
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Faculdade de Medicina Veterinária e Zootecnia de Botucatu, Botucatu, SP, Brazil
| | - Regina Célia Popim
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Faculdade de Medicina de Botucatu, Departamento de Enfermagem, Botucatu, SP, Brazil
| |
Collapse
|
|
39
|
Morteza Bagi H, Ahmadi S, Tarighat F, Rahbarghazi R, Soleimanpour H. Interplay between exosomes and autophagy machinery in pain management: State of the art. NEUROBIOLOGY OF PAIN (CAMBRIDGE, MASS.) 2022; 12:100095. [PMID: 35720640 PMCID: PMC9198378 DOI: 10.1016/j.ynpai.2022.100095] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 06/04/2022] [Accepted: 06/04/2022] [Indexed: 05/30/2023]
Abstract
Despite recent progress regarding inexpensive medical approaches, many individuals suffer from moderate to severe pain globally. The discovery and advent of exosomes, as biological nano-sized vesicles, has revolutionized current knowledge about underlying mechanisms associated with several pathological conditions. Indeed, these particles are touted as biological bio-shuttles with the potential to carry specific signaling biomolecules to cells in proximity and remote sites, maintaining cell-to-cell communication in a paracrine manner. A piece of evidence points to an intricate relationship between exosome biogenesis and autophagy signaling pathways at different molecular levels. A close collaboration of autophagic response with exosome release can affect the body's hemostasis and physiology of different cell types. This review is a preliminary attempt to highlight the possible interface of autophagy flux and exosome biogenesis on pain management with a special focus on neuropathic pain. It is thought that this review article will help us to understand the interplay of autophagic response and exosome biogenesis in the management of pain under pathological conditions. The application of therapies targeting autophagy pathway and exosome abscission can be an alternative strategy in the regulation of pain.
Collapse
Key Words
- Autophagy
- CESC-Exo, cartilage endplate stem cell-derived Exo
- Cell Therapy
- ER, endoplasmic reticulum
- ESCRT, endosomal sorting complex required for transport
- HSPA8, heat shock protein family A member 8
- LAMP2, lysosomal‑associated membrane protein type 2
- LAT1, large amino acid transporter
- LTs, leukotrienes
- MAPK8/JNK, mitogen-activated protein kinase 8p-/c-Jun N-terminal Kinase
- MMP, matrix metalloproteinase
- MVBs, multivesicular bodies
- NFKB/NF-κB, nuclear factor of kappa light polypeptide gene enhancer in B cells
- NPCs, nucleus pulposus cells
- NPCs-Exo, NPCs-derived Exo
- Neural Exosome
- Pain Management
- SNARE, soluble N-ethylmaleimide-sensitive factor attachment protein receptors
- TLR4, Toll-like receptor 4
- TRAF6, TNF receptor-associated factor 6
- nSMase, ceramide-generating enzyme neutral sphingomyelinases
Collapse
Affiliation(s)
- Hamidreza Morteza Bagi
- Emergency and Trauma Care Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sajjad Ahmadi
- Emergency and Trauma Care Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Faezeh Tarighat
- Emergency and Trauma Care Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Rahbarghazi
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Applied Cell Sciences, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hassan Soleimanpour
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
|
40
|
Wang J, Xu X. Effects of high-quality nursing on complications of peripherally inserted central catheter placement in patients with leukemia. Am J Transl Res 2022; 14:3472-3480. [PMID: 35702086 PMCID: PMC9185021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/30/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To determine the effects of high-quality nursing on negative emotions, treatment compliance, and complications of peripherally inserted central catheter (PICC) placement in patients with leukemia. METHODS A total of 87 patients with leukemia treated in our hospital from May 2018 to May 2020 were retrospectively enrolled and their clinical data were analyzed. The patients were assigned to a routine group (n=40) and a high-quality group (n=47) based on different nursing schemes. The self-rating depression scale (SDS) and self-rating anxiety scale (SAS) were used to compare the negative emotional changes in patients of the two groups, and the visual analogue scale (VAS) was used to analyze the degree of pain. The two groups were compared in treatment compliance, quality of life, incidence of complications of PICC placement, and nursing satisfaction. RESULTS After intervention, the high-quality group got significantly lower SDS and SAS scores than the routine group (both P<0.05). Compared with the routine group, the high-quality group showed higher treatment compliance and nursing satisfaction, experienced higher quality of life (all P<0.05), with also a lower total incidence of complications of PICC placement (P<0.01). CONCLUSION For patients with leukemia, high-quality nursing can substantially improve their psychological state, treatment compliance and nursing satisfaction, and reduce the incidence of complications of PICC placement.
Collapse
Affiliation(s)
- Juan Wang
- Department of Hematology, The First Affiliated Hospital of Soochow University Suzhou 215006, Jiangsu, China
| | - Xiaoli Xu
- Department of Hematology, The First Affiliated Hospital of Soochow University Suzhou 215006, Jiangsu, China
| |
Collapse
|
|
41
|
Sakulpisuti C, Chamroonrat W, Tepmongkol S. Cutaneous Management after Extravasation of High-Concentrated Amino Acid Solution Administered for Renal Protection in PRRT. Tomography 2022; 8:356-363. [PMID: 35202194 PMCID: PMC8880062 DOI: 10.3390/tomography8010029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/24/2022] [Accepted: 01/28/2022] [Indexed: 11/25/2022] Open
Abstract
High-concentrated amino acid solution is used to protect the kidneys during peptide receptor radionuclide therapy (PPRT) in patients with neuroendocrine tumors (NETs). Extravasation of the solution can cause cutaneous complications. In this study, we described a 66-year-old man with metastatic medullary thyroid cancer and a 32-year-old woman with metastatic pancreatic NET who developed cutaneous lesions caused by the extravasation of an amino acid solution (25 g of lysine and 25 g of arginine in 1 L of normal saline) during PRRT with [177Lu]Lu-DOTA-TATE. Both were treated conservatively, and these cutaneous lesions gradually improved. The patient with metastatic pancreatic NET rejected the amino acid infusion in subsequent cycles of PRRT and therefore received [177Lu]Lu-DOTA-TATE alone, and her serum creatinine level and estimated glomerular filtration rate (eGFR) remained normal for 2 months after the last treatment. These two cases revealed cutaneous complications resulting from high-concentrated amino acid solution during PRRT because of hyperosmolarity. Health care providers should be aware of this complication to ensure its prevention and appropriate management. Preserved renal function was demonstrated after [177Lu]Lu-DOTA-TATE treatment in the absence of the infusion of a high-concentrated amino acid solution. However, long-term follow-up of renal function is suggested.
Collapse
Affiliation(s)
- Chaninart Sakulpisuti
- Division of Nuclear Medicine, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand;
| | - Wichana Chamroonrat
- Division of Nuclear Medicine, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand;
- Correspondence:
| | - Supatporn Tepmongkol
- Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand;
- Chulalongkorn University Biomedical Imaging Group (CUBIG), Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| |
Collapse
|
|
42
|
Gong Z, Zhang J, Hou J, Chen S, Hu Z, Kong X, Ma G, Luo L. Drug Extravasation in a Large General Hospital in Hunan, China: A Retrospective Survey. Risk Manag Healthc Policy 2021; 14:4931-4938. [PMID: 34924775 PMCID: PMC8674494 DOI: 10.2147/rmhp.s318832] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 10/27/2021] [Indexed: 11/23/2022] Open
Abstract
Background and Aim Drug extravasation is one of the most common complications of intravenous therapy, which can lead to severe tissue injury if inappropriately treated. This study analyzes the current situation of extravasation and the risk factors affecting the severity of extravasation to provide a theoretical basis for carrying out prospective research, reducing the severity of drug extravasation, and strengthening the management of drug extravasation. Materials and Methods We retrieved the data on extravasation from January 2016 to December 2020 from the hospital’s safe infusion management system. We used nonparametric tests to assess the differences in the severity of drug extravasation among each variable and performed a multivariate analysis using multivariate ordered logistic regression. Results Extravasation occurred in 0.038% (263/694,043) of patients, including 203 cases of mild extravasation (77.2%), 57 cases of moderate extravasation (21.7%), and 3 cases of severe extravasation (1.1%). The main diseases of the patients with extravasation were cancer (24.7%), neurological-related diseases (19.4%), circulatory-related diseases (14.8%), and digestive-related diseases (14.1%); the main extravasated drugs were hypotonic or hypertonic drugs (31.9%) and contrast media (27.8%); the infusion tools of extravasation were indwelling needles (92.0%) and steel needles (8.0%). The multi-factor analysis showed that close to joints, patients’ age ≤6 or age >65, cancer, neurological-related diseases, circulatory-related diseases, antineoplastic agents, hypotonic or hypertonic drugs and strong acid or alkali drugs were independent risk factors for more severe extravasation. The nurses’ age and first identified by nurse were nurse-related factors that influenced the severity of drug extravasation. Conclusion To prevent the occurrence of drug extravasation and reduce its severity, the nurses should strengthen the learning of emergency plans related drug extravasation, strengthen inspections of high-risk patients. Besides, the managers should strengthen the risk warning management of high-risk extravasated drugs.
Collapse
Affiliation(s)
- Zhihong Gong
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China
| | - Jinghui Zhang
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China.,Xiangya Nursing School, Central South University, Changsha, Hunan, People's Republic of China
| | - Jianmei Hou
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China.,Department of Thoracic Oncology, Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China
| | - Shujie Chen
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China
| | - Zixin Hu
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China
| | - Xiaoya Kong
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China
| | - Guiyuan Ma
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China
| | - Lingxia Luo
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China.,Department of Emergency Medicine, Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China
| |
Collapse
|
|
43
|
Ehmke N. Chemotherapy Extravasation: Incidence of and Factors Associated With Events in a Community Cancer Center. Clin J Oncol Nurs 2021; 25:680-686. [PMID: 34800094 DOI: 10.1188/21.cjon.680-686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The administration of chemotherapy is a high-risk and nurse-sensitive practice. One complication is extravasation. OBJECTIVES The purpose of this study was to determine the incidence of and iatrogenic factors associated with extravasation in the ambulatory and inpatient settings of a community cancer center. METHODS Events were reviewed by agent, route of administration, patient characteristics, and RNs administering the agent. A one-year, retrospective review of electronic health records and pharmacy and nursing reports was conducted. FINDINGS The number of vesicants, irritants, and irritants with vesicant properties administered was 12,260 in the ambulatory setting and 612 on the inpatient unit, with 21 and 1 extravasation events, respectively. Incidence rates for both settings were 0.001%. The most common agent to extravasate was docetaxel, and all events occurred via peripheral route. The incidence of events was lower than the reported benchmark for National Cancer Institute-designated cancer centers.
Collapse
|
|
44
|
Huh S. The Journal Citation Indicator has arrived for Emerging Sources Citation Index journals, including the Journal of Educational Evaluation for Health Professions, in June 2021. JOURNAL OF EDUCATIONAL EVALUATION FOR HEALTH PROFESSIONS 2021; 18:20. [PMID: 34399568 PMCID: PMC8411047 DOI: 10.3352/jeehp.2021.18.20] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 07/20/2021] [Indexed: 05/28/2023]
Affiliation(s)
- Sun Huh
- Department of Parasitology and Institute of Medical Education, College of Medicine, Hallym University, Chuncheon, Korea
| |
Collapse
|
|
45
|
Nedomansky J, Haslik W, Pluschnig U, Kornauth C, Deutschmann C, Hacker S, Steger GG, Bartsch R, Mader RM. Tissue distribution of epirubicin after severe extravasation in humans. Cancer Chemother Pharmacol 2021; 88:203-209. [PMID: 33907881 PMCID: PMC8236455 DOI: 10.1007/s00280-021-04280-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 04/14/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE As critical parameter after extravasation of cytotoxic vesicants, anthracyclines were determined in removed tissue from patients requiring surgical intervention due to tissue necrosis. We monitored their distribution within the affected lesion to establish a possible dose-toxicity relation. METHODS From six patients scheduled for surgery, removed tissue flaps were systematically analysed by HPLC (epirubicin: 5 subjects; doxorubicin: 1 subject). RESULTS After extravasation, tissue concentrations were highly variable with an individual anthracycline distribution pattern ranging from a few nanograms up to 17 µg per 100 mg tissue, which indicated a substantial difference in tissue sensitivity among patients. The resection borders coincided with the extension of the erythema and guided the surgical intervention after demarcation of the lesion, which occurred usually 2 or 3 weeks after extravasation. At that time, drug was hardly detected at the resection borders. Wound drains were negative for the extravasated drugs while showing a time profile of vascular growth factors and inflammatory cytokines, which was highly similar to routine surgery. In all six patients, surgical debridement with immediate wound closure led to healing within approximately 2 weeks, when therapy was resumed in all patients with reasonable time delay. CONCLUSION Surgical intervention after demarcation of the extravasation lesion allows for almost uninterrupted continuation of treatment independent of the amount of extravasated anthracycline. As even minor amounts of the vesicants may trigger tissue necrosis, preventive measures merit the highest priority.
Collapse
Affiliation(s)
- Jakob Nedomansky
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Comprehensive Cancer Center of the Medical University of Vienna, Vienna, Austria
| | - Werner Haslik
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Comprehensive Cancer Center of the Medical University of Vienna, Vienna, Austria
| | - Ursula Pluschnig
- Department of Medicine I, Clinical Division of Oncology, Comprehensive Cancer Center of the Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Christoph Kornauth
- Department of Pathology, Comprehensive Cancer Center of the Medical University of Vienna, Vienna, Austria
| | - Christine Deutschmann
- Department of Obstetrics and Gynecology, Comprehensive Cancer Center of the Medical University of Vienna, Vienna, Austria
| | - Stefan Hacker
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Comprehensive Cancer Center of the Medical University of Vienna, Vienna, Austria
| | - Günther G Steger
- Department of Medicine I, Clinical Division of Oncology, Comprehensive Cancer Center of the Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Rupert Bartsch
- Department of Medicine I, Clinical Division of Oncology, Comprehensive Cancer Center of the Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Robert M Mader
- Department of Medicine I, Clinical Division of Oncology, Comprehensive Cancer Center of the Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
| |
Collapse
|
|
46
|
Evidence-Based Medicine G, Neonatologist S, Chinese Medical Doctor A. [Guidelines for neonatal skin management in the neonatal intensive care unit (2021)]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2021; 23:659-670. [PMID: 34266521 PMCID: PMC8292657 DOI: 10.7499/j.issn.1008-8830.2106004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 06/22/2021] [Indexed: 06/13/2023]
Abstract
Neonates are easily suffering from local or systematic infections due to their vulnerable skin barrier function, which leads to the increasing risk of death. Therefore, it is important to protect neonatal skin integrity and prevent neonatal skin injury in the neonatal intensive care unit (NICU). Based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and current evidence, the guidelines for neonatal skin management in the NICU were developed to provide recommendations on routine skin care and prevention and treatment of iatrogenic skin injury of neonates for health care providers.
Collapse
|
|
47
|
Evidence-Based Medicine G, Neonatologist S, Chinese Medical Doctor A. [Guidelines for neonatal skin management in the neonatal intensive care unit (2021)]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2021; 23:659-670. [PMID: 34266521 PMCID: PMC8292657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 06/22/2021] [Indexed: 09/21/2023]
Abstract
Neonates are easily suffering from local or systematic infections due to their vulnerable skin barrier function, which leads to the increasing risk of death. Therefore, it is important to protect neonatal skin integrity and prevent neonatal skin injury in the neonatal intensive care unit (NICU). Based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and current evidence, the guidelines for neonatal skin management in the NICU were developed to provide recommendations on routine skin care and prevention and treatment of iatrogenic skin injury of neonates for health care providers.
Collapse
|
|
48
|
Measuring the Validity and Reliability of the Vascular Access Complication Staging and Treatment Instrument in a Pediatric Population. JOURNAL OF INFUSION NURSING 2021; 44:225-243. [PMID: 34197352 DOI: 10.1097/nan.0000000000000431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A multiphase study designed with Delphi and observational components was conducted to establish the preliminary validity and reliability of the 2018 Vascular Access Complication Staging and Treatment Instrument in pediatric and neonatal populations from a single, free-standing academic children's hospital. The instrument uses objective measurement criterion to determine the severity of swelling and tissue damage to inform treatment decisions. The results of the study provided preliminary empirical evidence to support a pediatric and neonatal intravenous complication staging instrument to assess degree of swelling and severity of tissue injury. The study also offered preliminary evidence that the instrument was perceived by the nurses who participated in the study to be efficient and easy to use.
Collapse
|
|
49
|
Santos LMD, Nunes KDJ, Silva CSGE, Kusahara DM, Rodrigues EDC, Avelar AFM. Elaboration and validation of an algorithm for treating peripheral intravenous infiltration and extravasation in children. Rev Lat Am Enfermagem 2021; 29:e3435. [PMID: 34190937 PMCID: PMC8253344 DOI: 10.1590/1518-8345.4314.3435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 09/12/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to elaborate and validate the content and appearance of an algorithm for treating infiltration and extravasation of non-chemotherapy drugs and solutions administered to children. METHOD a methodological study of the technology formulation and validation type. To elaborate the algorithm, a bibliographic review was carried out to list the scientific evidence on the treatment of infiltration and extravasation. Content and appearance validation was in charge of 14 specialists in pediatric nursing, using the Delphi technique, adopting a value equal to or greater than 0.80 as Content Validation Index. RESULTS the algorithm was validated in the third evaluation by the judges, reaching a Global Content Validation Index of 0.99, being composed by the perception of the occurrence of the complication; discontinuation of intravenous therapy infusion; verification of signs and symptoms; measurement of edema; application of an infiltration and extravasation assessment scale and conduits to be used according to the characteristics of the fluid administered and the type of complication. CONCLUSION the algorithm was validated and can be used in a practical and objective way by health professionals, in order to promote safety in the care of hospitalized children, with regard to reducing harms caused by infiltration and extravasation.
Collapse
Affiliation(s)
- Luciano Marques Dos Santos
- Universidade Estadual de Feira de Santana, Departamento de Saúde, Feira de Santana, BA, Brazil.,Universidade Federal de São Paulo, Escola Paulista de Enfermagem, São Paulo, SP, Brazil
| | | | | | | | | | | |
Collapse
|
|
50
|
Lu YX, Wu Y, Liang PF, Wu RC, Tian LY, Mo HY. Efficacy of combination of localized closure, ethacridine lactate dressing, and phototherapy in treatment of severe extravasation injuries: A case series. World J Clin Cases 2021; 9:4599-4606. [PMID: 34222426 PMCID: PMC8223846 DOI: 10.12998/wjcc.v9.i18.4599] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/24/2021] [Accepted: 04/06/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The management of severe extravasation injuries is still controversial. Extravasation injuries can be treated in many ways.
AIM To present a series of patients with severe extravasation injuries due to infusion who were managed with ethacridine lactate dressing combined with localized closure and phototherapy.
METHODS In this study, we evaluated the data of eight patients, including six from the Department of Burn, one (with colorectal carcinoma) from the Veteran Cadre Department, and one (with leukemia) from the Hematology Department. Of these, three patients were male and five were female. Age of the patients ranged from 10 mo to 72 years, including two children (10 and 19 mo of age). In this study, the infusion was stopped immediately when the extravasation was identified. The extravasation event was managed routinely using a blocking solution. A ring-shaped localized closure was performed using the blocking agents. Moreover, ethacridine lactate dressing and phototherapy were applied for 3-5 d.
RESULTS In this study, the drugs contained in the infusates were iodixanol, norepinephrine, alprostadil, amino acids, fat emulsion, cefoselis, cefoxitin, and potassium chloride + concentrated sodium chloride. All of the patients achieved complete healing after treatment and no obvious adverse reactions were observed.
CONCLUSION The treatment of severe extravasation injuries using a combination of localized closure, ethacridine lactate dressing, and phototherapy resulted in satisfactory outcomes in patients.
Collapse
Affiliation(s)
- Yan-Xu Lu
- Xiangya Stomatological Hospital & School of Stomatology , Central South University, Changsha 410000, Hunan Province, China
| | - Ying Wu
- Teaching and Research Section of Clinical Nursing, Department of Burn and Reconstructive Surgery, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China
| | - Peng-Fei Liang
- Department of Burn and Reconstructive Surgery, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China
| | - Rong-Chan Wu
- Phase 1 Clinical Trial Center, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China
| | - Ling-Yun Tian
- School of Nursing, Anhui University of Chinese Medicine, Hefei 230012, Anhui Province, China
| | - Hui-Ying Mo
- Department of Burn and Reconstructive Surgery, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China
| |
Collapse
|