Intrathoracic extravasation of sclerosing agents associated with central venous catheters.

Two children receiving continuous infusions of vesicant chemotherapy through central venous catheters (CVCs) developed venous thrombosis, and intrathoracic extravasations ensued. One child receiving a continuous vincristine infusion presented with signs of thoracic venous obstruction, fever, and respiratory distress and had pleural effusions and pulmonary infiltrates on his chest roentgenogram. The other child was receiving a continuous doxorubicin infusion and developed superior vena cava thrombosis and retrograde extravasation along the catheter tunnel site. Both children improved after chemotherapy was discontinued and the CVCs removed. Catheter placement and the continuous infusion of sclerosing agents are discussed.