INTRODUCTION: Extravasation injuries are a common and challenging problem in hospitalized newborns. Accidental infusion leakage into the surrounding tissues in immature infants may frequently result in skin necrosis, with significant risk of functional and cosmetic impairment. MATERIAL AND METHODS: In the present study we reviewed 34 cases of severe extravasation injuries occurring in 1,409 neonates hospitalized in a single neonatal unit over 24 months (incidence 2.4%). Total parenteral nutrition solutions were involved in most cases. All patients were treated within 30 minutes after the injury was recorded using a flush-out technique with normal saline irrigation and occlusive paraffin dressings of the infiltrated area. RESULTS: The majority of injuries affected preterm, low-birthweight infants (mean gestation 32 wks + 6 days, mean birth weight 1,885 g), with a mean age at the time of injury of 11.6 days and a mean weight of 2,045 g. Neither gestational age (p = 0.87) or birthweight significantly affected (p = 0.07) the incidence of extravasation injuries, although the incidence of skin necrosis had a significant correlation with gestational age (p = 0.009) and birthweight (p < 0.001). All patients responded well to treatment and their wounds healed uneventfully within a maximum of 25 days without the need for secondary surgery for skin coverage. CONCLUSION: Extravasation injuries in extremely preterm and low-birthweight infants are more likely to lead to skin necrosis. Peripheral venous catheterization should be performed with caution in these patients to prevent such injuries. Immediate irrigation with normal saline is recommended to reduce toxic sequelae in the infiltrated area.
INTRODUCTION: Extravasation injuries are a common and challenging problem in hospitalized newborns. Accidental infusion leakage into the surrounding tissues in immature infants may frequently result in skin necrosis, with significant risk of functional and cosmetic impairment. MATERIAL AND METHODS: In the present study we reviewed 34 cases of severe extravasation injuries occurring in 1,409 neonates hospitalized in a single neonatal unit over 24 months (incidence 2.4%). Total parenteral nutrition solutions were involved in most cases. All patients were treated within 30 minutes after the injury was recorded using a flush-out technique with normal saline irrigation and occlusive paraffin dressings of the infiltrated area. RESULTS: The majority of injuries affected preterm, low-birthweight infants (mean gestation 32 wks + 6 days, mean birth weight 1,885 g), with a mean age at the time of injury of 11.6 days and a mean weight of 2,045 g. Neither gestational age (p = 0.87) or birthweight significantly affected (p = 0.07) the incidence of extravasation injuries, although the incidence of skin necrosis had a significant correlation with gestational age (p = 0.009) and birthweight (p < 0.001). All patients responded well to treatment and their wounds healed uneventfully within a maximum of 25 days without the need for secondary surgery for skin coverage. CONCLUSION: Extravasation injuries in extremely preterm and low-birthweight infants are more likely to lead to skin necrosis. Peripheral venous catheterization should be performed with caution in these patients to prevent such injuries. Immediate irrigation with normal saline is recommended to reduce toxic sequelae in the infiltrated area.
Authors: Mark Corbett; David Marshall; Melissa Harden; Sam Oddie; Robert Phillips; William McGuire Journal: BMC Pediatr Date: 2019-01-07 Impact factor: 2.125
Authors: Katelyn Sushko; Catherine Litalien; Lauren Ferruccio; Andrea Gilpin; Maryann Mazer-Amirshahi; Anthony K Chan; John van den Anker; Thierry Lacaze-Masmonteil; Samira Samiee-Zafarghandy Journal: CMAJ Open Date: 2021-03-17
Authors: Roslind K Hackenberg; Koroush Kabir; Andreas Müller; Andreas Heydweiller; Christof Burger; Kristian Welle Journal: Dtsch Arztebl Int Date: 2021-08-23 Impact factor: 8.251
Authors: Max Little; Sophie Dupré; Justin Conrad Rosen Wormald; Matthew Gardiner; Chris Gale; Abhilash Jain Journal: BMJ Open Date: 2020-08-06 Impact factor: 2.692
Authors: Kam Ming Chan; Janita Pak Chun Chau; Kai Chow Choi; Genevieve Po Gee Fung; Wai Wa Lui; Meme Suk Ying Chan; Suzanne Hoi Shan Lo Journal: BMC Pediatr Date: 2020-09-23 Impact factor: 2.125