Surgical intervention for paediatric infusion-related extravasation injury: a systematic review

Little, Max; Dupré-Crochet, Sophie; Wormald, Justin C.R.; Gardiner, Matthew; Gale, Chris; Jain, Abhilash

doi:10.1136/bmjopen-2019-034950

Cited by 4 publications

(2 citation statements)

References 40 publications

(37 reference statements)

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“…Moreover, the rate of 70% refers to neonates with intravenous therapy [ 4 , 8 ]. Extravasation injury has different underlying factors, including deracination of intravenous line access, vascular fragility, or reverse run of drugs to the interstitial space due to vein blockage [ 2 , 4 , 9 , 10 ]. Extravasation is categorized into four stages:…”

Section: Introductionmentioning

confidence: 99%

A new approach to skin extravasation injury management during the neonatal period

2022

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Background To identify a standard protocol for managing extravasation injuries in neonates. Methods We recruited all the neonates with extravasation wounds from the neonatal intensive care unit of Shariati hospital, Tehran, Iran, between October 2018 and October 2020. Sixteen patients with grade 3–4 extravasation were evaluated in this retrospective study. All grade 3 and 4 extravasation wounds were injected with hyaluronidase at 5 points of the wound circle; the procedure was repeated every 5 min at different points in a smaller circle to the core. The wound was then covered with a warm compress for 24 h. Twenty-four hours after injection, the cover was changed twice a day with normal saline irrigation. Fibrinolysin ointment was applied on top of the wound. The ulcer was then dressed with phenytoin ointment until healing. Results Out of 16 neonates who were followed up, 10 of them were male, with the average birth weight being 1.37 (range 1.05–3.75) kg. The mean (± SD) wound healing duration was 13.12 (± 6) (range: 7–29) days. Factors including the cannulation duration before the appearance of the lesion (R:0.2, P = 0.2), birth weight (R = -.37, P = 015), and extravasated substances (p = 0.2) were not associated with the duration of hospital stay. The only exception to this trend is the wound size factor of 7.31(± 7.45) (R = .83, P < 0.001). Continuous and categorical variables were summarized as mean (SD) and proportions, respectively, and the Kruskal–Wallis test and Spearman correlation coefficients were used. Conclusions Limited evidence exists on the effects of different protocols on extravasation management in neonates in the NICU. We recommend our method as a standard protocol in NICU for high-stage extravasated lesions because of the shorter duration of healing, non-invasive nature of this procedure, and lack of side effects or surgical involvement.

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Section: Introductionmentioning

confidence: 99%

A new approach to skin extravasation injury management during the neonatal period

2022

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“…Extravasation injury and inhaled drug-induced tissue toxicity to the nasopharyngeal and bronchial area might be comparable. Extravasation injuries can be extremely complicated with local recycling of absorbed drug, multiple surgical interventions, and even amputations in pediatric patients (13). At least in theory, upon direct contact with tissues, inhaled protein should not result in vesicant injury as compared to cytotoxic compounds.…”

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confidence: 99%

Atezolizumab Retains Cellular Binding to Programmed Death Ligand 1 Following AerosolizationviaMesh Nebulizer

ZALESKIS¹,

TALAIKIS²,

Characiejus³

et al. 2023

Anticancer Res

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Background/Aim: Cytotoxic inhalable drugs were shown to be advantageous in treating malignancies of the respiratory tract. However, these drugs have not always presented a safe profile and were reported to induce local adverse events. Protein-based anticancer drugs, such as immune checkpoint and vascular endothelial growth factor inhibitors, do not induce tissue injury, nor do they exhibit vesicant properties upon direct contact with tissues. Protein drugs are susceptible to the heat and stress encountered during droplet generation for delivery by nebulization. The aim of this study was to investigate the capacity of atezolizumab, an antibody to programmed death ligand 1, to bind target cells after nebulization with a vibrating mesh (VM) nebulizer. Materials and Methods: We compared Fourier-transformed infrared (FTIR) and Raman spectra of native atezolizumab (60 mg/ml) and its nebulized form following 10-min nebulization in a piezoceramic VM nebulizer. The binding of atezolizumab to DU-145 prostate cancer cells was evaluated using competitive blocking of anti-CD274 staining. Results: Nebulization did not induce Raman or FTIR spectral modification nor did it affect the binding capacity of atezolizumab. Conversely, heat-inactivated atezolizumab lost its cell-binding capacity and did not reduce anti-CD274

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Complications of Treatment

Bhatnagar

2022

Wilms’ Tumor

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Surgical intervention for paediatric infusion-related extravasation injury: a systematic review

Cited by 4 publications

References 40 publications

A new approach to skin extravasation injury management during the neonatal period

A new approach to skin extravasation injury management during the neonatal period

Atezolizumab Retains Cellular Binding to Programmed Death Ligand 1 Following AerosolizationviaMesh Nebulizer

Complications of Treatment

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