Extravazarea

Extravazarea (extravasation) is the unintended leakage of intravenous fluids, medications, or contrast media from a blood vessel into surrounding tissue. It can occur with peripheral IV lines or central venous access and may cause tissue injury when vesicant agents are involved.

Causes include improper cannula placement, fragile or injured veins, catheter dislodgement, high infusion pressure or rate, and administration of vesicant or irritant drugs. Patient factors such as age, skin integrity, and poor venous condition increase risk.

Clinical features include sudden swelling at the infusion site, pain or burning, redness, cool skin, and decreased infusion flow. In severe cases, blistering or tissue necrosis may develop.

Immediate management: stop the infusion and remove the cannula when safe. Attempt gentle aspiration, avoid reinjection, and reassess. Apply appropriate local measures (cold compresses for most agents; warm compresses if advised). Follow institutional protocols; consider antidotes or referral for severe cases.

Prevention focuses on correct IV technique, verifying catheter position and patency, rotating sites, using central access for vesicants when feasible, and monitoring infusion sites. Outcomes depend on the drug and amount extravasated, ranging from mild irritation to significant tissue injury requiring surgical intervention.