Extravasation of iodinated contrast medium in cancer patients undergoing computed tomography

Abstract

ObjectiveThe aim of this study was to evaluate the incidence of extravasation of iodinated contrast medium (ICM) at the site of intravenous injection in oncology patients submitted to computed tomography (CT).Materials and MethodsThis was a retrospective, descriptive, single-center study that evaluated all patients who underwent CT with ICM administration and presented ICM extravasation, at a cancer center, between January 2010 and December 2015.ResultsDuring the study period, we evaluated a total of 99,076 ICM injections and identified 199 cases of extravasation, the incidence rate therefore being 0.20%. Among the patients who presented extravasation, the mean age was 59.22 years and 60% were female. The extravasation was classified as mild in 94.10% of the patients and as moderate in 5.90%. There were no cases of severe extravasation in the sample.ConclusionThe incidence of ICM extravasation in cancer patients submitted to CT in the present study was similar to that reported for the general population, according to other studies in the literature. The vast majority of cases of extravasation were considered mild, and no severe cases were observed in the study sample.

Incidência e tipo de traumatismo vascular periférico em pessoas submetidas a exames de diagnóstico por imagem

“…The gadolinium contrast medium used in MRI is considered less toxic than the iodinated contrast medium used in TC. However, they do not usually cause more severe lesions because, in MRIs, the contrast is injected in smaller volumes than in CTs (Silva, Bitencourt, & Chojniak, 2018). The physical-chemical properties of contrast media require the need for monitoring their infusion more frequently because characteristics such as viscosity and hyperosmolarity increase the chances of occurrence of extravasation (Rose & Choi, 2015).…”

The performance of the nursing team in outpatient radiology and diagnostic imaging services

“…In addition, there are maneuvers that can be performed to confirm the intravenous location of the catheter inserted in the peripheral vein, since the CM can be introduced at increased speed. The injection of contrast must be monitored and followed up by the nursing staff, since the risk of extravasation is increase and, if it occurs, there will be an opportunity to minimize the damage (17,18) . Contrast extravasation is not only a concern for healthcare teams; it also affects other teams, as it is associated with different risks, which, depending on the patient, can include fragile blood vessels, a need to do the puncture with metallic needles instead of plastic catheters or to provide chemotherapy treatment before the administration of the Rev Gaúcha Enferm.…”

A atuação da equipe de enfermagem em serviços ambulatoriais de radiologia e diagnóstico por imagem

“…Nos SRDIA a preparação cuidadosa da punção venosa realizada pela enfermagem é essencial para minimizar o risco do extravasamento e ainda, manobras podem ser realizadas para confirmar a localização intravenosa do cateter, inserido na veia periférica, uma vez que o MC poderá ser introduzido em velocidade aumentada. A injeção do contraste deve ser monitorada e acompanhada pela enfermagem, uma vez que aumenta o risco de extravasamento, assim sendo, caso ocorra, haverá a oportunidade de minimização do dano (17,18) .…”