Sensing Technologies for Extravasation Detection: A Review

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.

The Clinical and Economic Burdens of Infiltration and Extravasation with Peripheral Intravenous Catheters: A Contemporary Narrative Review

“…Furthermore, clinical examination of signs and symptoms may not be sensitive enough to detect cases of infiltration and extravasation in earlier stages. Alternatively, the use of technologies including ultrasound may be useful for early detection of infiltration and extravasation [68]. A study of PIVC failure in adults found that 9.7% of participants presented with subcutaneous edema on clinical exam, versus 56.5% of participants based on ultra sonographic evaluation [18].…”

Comment on “Sensing Technologies for Extravasation Detection: A Review”

“…One of the leading complications associated with PIVCs is peripheral intravenous infiltration/extravasation (PIVIE), with long periods of minimally impactful innovations that protect the patient from this form of associated injury. Most importantly is the early identification of PIVIE, which also has been discussed by the authors . In many clinical situations, extravasation may be from several clinical aspects: posterior vessel wall puncture, increased vein porosity, catheter lumen rupture (from excessive pressure or power injection procedures), or unexpected device failure, all of which share a common element, infiltration into the surrounding subcutaneous tissue.…”

“…We recently read with interest the publication from Hirata and colleagues who discussed extravasation and its associated mechanisms of applied sensing monitoring technologies for preventative strategies with intravascular devices. While the authors mentioned the basic procedural aspects of venous cannulation, they additionally could have discussed more widely accepted technologies for device placement.…”

“…Despite the novelty of these technologies, device availability, user/patient friendliness, clinically demonstrated outcome improvements, and device cost-effectiveness within the clinical setting are still required . Although Hirata et al describe in detail several available sensing technologies, the authors could have provided more recent evidence in the use of these products in the clinical setting. To the best of our knowledge, benchmarking evidence is not yet available to provide comparisons.…”

Reply to the Comment on “Sensing Technologies for Extravasation Detection: A Review”

“…We recently received and checked your Comment about our latest Review in ACS Sensors entitled “Sensing Technologies for Extravasation Detection: A Review” 1 and we appreciate the interest it has generated in the scientific community.…”