Incidence, risk factors and treatment outcomes of drug extravasation in pediatric patients in China

Abstract

Extravasation injury is a common phenomenon in hospitals. Failure to detectand treat extravasation injury can lead to irreversible local injuries, tissuenecrosis and malfunction of the affected tissue. Until now, it is largely unknownabout incidence, risk factors and treatment outcomes of extravasation inChinese pediatric patients. The aim of this study is to explore the incidence,risk factors and summarize the characteristics and treatment outcomes ofextravasation injuries resulting in drug extravasation among Chinese childrenin our hospital. The children undergoing infusion therapy (0-18 years) wereenrolled in this study between December 2014 and June 2015 in ShanghaiChildren’s Hospital. The patients’ information including age, gender, injectionsite, estimated volume of solution extravasated, patient symptoms, severityof extravasation injury, treatment methods, and outcomes was collected.Multivariate logistic regression was used to identify the independent riskfactors for the development of extravasation. The incidence of extravasationsin pediatric patients was 1.79% (18/1,004). The severity of extravasation waslabeled with grade range from Grade 1 through Grade 4: 4 cases with Grade1, 8 cases with Grade 2, 5 cases with Grade 3, and 1 case with Grade 4. Therisk factors of extravasation include infused high volume/day (≥1000 ml),received operation, infused agents with high osmolarity and poor vein condition.The severity of extravasation was related to the large volumes of drug orspecial drugs (high-osmolarity, high-risk, low pH, etc). All extravasations weretreated with physical, pharmacological and surgical intervention according toour standard operation protocols. Systematic implementation of interventioncan alleviate the extravasation injuries and improve the patients’ outcome.