Emergency treatment of accidental infusion leakage in the newborn: report of 14 cases

Casanova, Dominique; Bardot, J.; Magalon, G.

doi:10.1054/bjps.2001.3593

Cited by 54 publications

(47 citation statements)

References 19 publications

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“…It degrades hyaluronic acid which promotes an increase in tissue permeability and absorbtion of fluids through tissues. Successful treatment of extravasation injuries with injection of hyaluronidase have been reported both in experimental animal models and in neonates (13)(14)(15). Phentolamine is a nonspecific alpha adrenergic blocker which has been shown to decrease clinical erythema, induration and blanching by inhibiting vasoconstriction and allowing improved blood circulation through the extravasation site (16).…”

Section: Discussionmentioning

confidence: 99%

Hyperbaric Oxygen Therapy In Calcium Chloride Extravasation Injuries: An Experimental Animal Study

et al. 2007

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Aim: Parenteral alimentation fluids containing calcium are widely used to treat sick neonates and children. Extravasation of calcium presents with local swelling, erythema, blistering and progresses to skin necrosis and skin loss. Several treatment modalities including hyperbaric oxygen therapy have been used for extravasation injuries. The role of hyperbaric oxygen therapy on extravasation injuries was investigated in this study by an experimental rat model based on facilitating effect of hyperbaric oxygen on wound healing.Methods: After shaving the dorsal side of 16 female Wistar rats, 1 ml of calcium chloride were injected intradermally. The rats were divided into two groups as control and hyperbaric oxygen. The control group received no treatment while the hyperbaric oxygen group received hyperbaric oxygen therapy for 7 days after injection. At the end of seventh day skin biopsy including all necrotic tissue and surrounding healthy tissue were obtained and histopathologic examination was performed for control and hyperbaric oxygen groups.Results: Hyperbaric oxygen group showed a statistically significant preservation of epidermis and dermis with minimal necrosing findings of skin injury.Conclusion: Although further research is required to develop management guidelines, we concluded that in this experimental study, hyperbaric oxygen therapy prevents dermal injury and may decrease the morbidity associated with calcium chloride extravasation injury.

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Section: Discussionmentioning

confidence: 99%

Hyperbaric Oxygen Therapy In Calcium Chloride Extravasation Injuries: An Experimental Animal Study

et al. 2007

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“…Seven studies reported using a flush-out technique, 4,21,31,32,41,42,57 with sample sizes ranging from 14 to 96 patients. All but one of the studies 21 was published after the year 2000.…”

Section: Flush-out Methodsmentioning

confidence: 99%

“…Two studies were prospective case series, 32,57 with the remainder being retrospective case series (or having unclear methods). 4,21,31,[41][42][43] Four studies used hyaluronidase before saline flush-out 21,31,42,57 and three used saline flush-out alone in all patients, 4,32 or nearly all patients. 41 Two studies additionally used liposuction in nearly all patients 42 or only in a few patients.…”

Section: Flush-out Methodsmentioning

confidence: 99%

“…21,31,32,57 Most studies were published as full papers, but the exceptions were two studies that were published as letters. 32,33 The included studies covered conservative management interventions (n = 7), [34][35][36][37][38][39][40] flush-out methods with or without hyaluronidase (n = 7), 4,21,31,32,41,42,57 hyaluronidase injections without flush out (n = 2), 45,46 artificial skin treatments (n = 2), 33,41 and debridement and/or plastic surgery (n = 7). …”

Section: Non-comparative Group Studiesmentioning

confidence: 99%

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Treatment of extravasation injuries in infants and young children: a scoping review and survey

Corbett

Marshall

Harden

et al. 2018

Health Technol Assess

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BackgroundExtravasation injuries are caused by unintended leakages of fluids or medicines from intravenous lines, but there is no consensus on the best treatment approaches.ObjectivesTo identify which treatments may be best for treating extravasation injuries in infants and young children.DesignScoping review and survey of practice.PopulationChildren aged < 18 years with extravasation injuries and NHS staff who treat children with extravasation injuries.InterventionsAny treatment for extravasation injury.Main outcome measuresWound healing time, infection, pain, scarring, functional impairment, requirement for surgery.Data sourcesTwelve database searches were carried out in February 2017 without date restrictions, including MEDLINE, CINAHL (Cumulative Index to Nursing and Allied Health Literature) Plus and EMBASE (Excerpta Medica dataBASE).MethodsScoping review – studies were screened in duplicate. Data were extracted by one researcher and checked by another. Studies were grouped by design, and then by intervention, with details summarised narratively and in tables. The survey questionnaire was distributed to NHS staff at neonatal units, paediatric intensive care units and principal oncology/haematology units. Summary results were presented narratively and in tables and figures.ResultsThe evidence identified in the scoping review mostly comprised small, retrospective, uncontrolled group studies or case reports. The studies covered a wide range of interventions including conservative management approaches, saline flush-out techniques (with or without prior hyaluronidase), hyaluronidase (without flush-out), artificial skin treatments, debridement and plastic surgery. Few studies graded injury severity and the results sections and outcomes reported in most studies were limited. There was heterogeneity across study populations in age, types of infusate, injury severity, location of injury and the time gaps between injury identification and subsequent treatment. Some of the better evidence related to studies of flush-out techniques. The NHS survey yielded 63 responses from hospital units across the UK. Results indicated that, although most units had a written protocol or guideline for treating extravasation injuries, only one-third of documents included a staging system for grading injury severity. In neonatal units, parenteral nutrition caused most extravasation injuries. In principal oncology/haematology units, most injuries were due to vesicant chemotherapies. The most frequently used interventions were elevation of the affected area and analgesics. Warm or cold compresses were rarely used. Saline flush-out treatments, either with or without hyaluronidase, were regularly used in about half of all neonatal units. Most responders thought a randomised controlled trial might be a viable future research design, though opinions varied greatly by setting.LimitationsPaucity of good-quality studies.ConclusionsThere is uncertainty about which treatments are most promising, particularly with respect to treating earlier-stage injuries. Saline flush-out techniques and conservative management approaches are commonly used and may be suitable for evaluation in trials.Future workConventional randomised trials may be difficult to perform, although a randomised registry trial may be an appropriate alternative.FundingThe National Institute for Health Research Health Technology Assessment programme.

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“…Moreover, we will group various aspects with the aim of finding the right protocol to follow when dealing with extravasation injuries caused by antiblastic drugs [9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Surgical treatment of extravasation injuries

Napoli

Corradino

Badalamenti

et al. 2005

Journal of Surgical Oncology

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The authors present their experience of treating anti-cancer drug extravasation by means of a composite surgical technique that consists of infiltration with physiological solution and hyaluronidase and subsequent manual aspiration of solutes alternated with profuse irrigation of the infiltrated area. In the immediate post-op we carry out a medical therapy that consists of calciparine and topic antibiotic and/or steroid creams. Since the year 2000 this technique has been used on 25 patients. We have had neither complications nor scars.

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Emergency treatment of accidental infusion leakage in the newborn: report of 14 cases

Cited by 54 publications

References 19 publications

Hyperbaric Oxygen Therapy In Calcium Chloride Extravasation Injuries: An Experimental Animal Study

Hyperbaric Oxygen Therapy In Calcium Chloride Extravasation Injuries: An Experimental Animal Study

Treatment of extravasation injuries in infants and young children: a scoping review and survey

Surgical treatment of extravasation injuries

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