Extravasationinduced

Extravasationinduced refers to tissue injury that occurs when intravenous fluids or drugs leak from the vascular space into surrounding tissue. This can result from infiltration during peripheral venous access or leakage around an indwelling catheter. The severity depends on the agent, concentration, volume, and the timeliness of intervention.

Agents commonly implicated include vesicants such as certain chemotherapeutic drugs (for example, anthracyclines and vinca alkaloids), irritants, and vasopressors. Vesicants are more likely to cause local necrosis and ulceration, while irritants can cause inflammation and pain without widespread tissue loss. Vasopressors may induce ischemic injury through potent local vasoconstriction. Nonvesicant infusions can also produce mild discomfort, swelling, and restricted movement.

Clinical presentation typically includes sudden onset pain at the infusion site, swelling, redness or blanching, cooling or warmth around the area, and tenderness. Progressive signs may include bullae, skin changes, and, in severe cases, necrosis. Risk factors include poor IV access, small or fragile veins, prolonged or high-concentration infusions, use of peripheral lines for vesicants, and patient factors such as age or underlying vascular disease.

Management emphasizes prompt recognition and intervention. Immediate steps usually include stopping the infusion, leaving the cannula in place to aspirate residual drug, and removing the catheter if necessary. Elevation of the limb, and local temperature management (which may vary by agent) are often used. Specific antidotes or measures depend on the agent: dexrazoxane for certain anthracyclines, phentolamine for vasopressor extravasation, and hyaluronidase-based treatment for some non-vasopressor extravasations, following institutional protocols.

Prevention focuses on proper IV access, using central venous lines for high-risk drugs when feasible, careful monitoring during infusions, and rapid response to early signs of infiltration. Prognosis varies with agent and intervention timing, but early management improves outcomes.