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首页> 外文期刊>The Canadian journal of hospital pharmacy. >Describing Intravenous Extravasation in Children (DIVE Study)
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Describing Intravenous Extravasation in Children (DIVE Study)

机译：描述儿童静脉外渗（DIVE研究）

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Background: Extravasation, the inadvertent leakage of intravenous (IV) medication from the vein into the surrounding tissue, is a iatrogenic cause of patient injury. Extravasation has been reported to occur in 0.1% to 6.5% of hospital inpatients. The incidence may be higher among children because they have multiple risk factors, including small and fragile veins, decreased peripheral circulation, capillary leakage, and flexible subcutaneous tissue. Objectives: To describe the incidence of extravasation at a pediatric tertiary care hospital, to identify the agents causing extravasation, and to describe the use of antidotes to manage identified cases. A secondary objective was to describe adverse drug effects associated with the antidotes administered. Methods: The medical records of pediatric patients with documented extravasation of an IV medication between January 1, 2006, and August 31, 2008, were analyzed retrospectively. The appropriateness of antidote use was determined in terms of adherence to the institutions protocol for treatment of extravasation. Results: A total of 42 patients had documented extravasation, for an overall incidence of 0.04% per patient-day. Of the 40 cases in which location was documented, 12 (30%) occurred on the general pediatric wards, 10 (25%) on the surgical ward, 9 (22%) in the neonatal intensive care unit, 5 (12%) in the pediatric intensive care unit, 3 (8%) in day care, and 1 (2%) in the emergency department. The most common medications involved were fluids for IV administration (18 [43%]), potassium chloride (11 [26%]), antibiotics (8 [19%]), total parenteral nutrition (8 [19%]), calcium chloride (2 [5%]), and epinephrine (2 [5%]). Multiple drugs were involved in some cases of extravasation. The decision to administer an antidote and the choice of antidote (if required) were appropriate in 50% of the cases. No adverse drug effects were reported with use of antidotes. Conclusions: The incidence of extravasation was low. The medications most commonly involved were similar to those reported in the literature. Antidotes were well tolerated but were appropriately used in only half of the events. Prospective trials are needed to determine the clinical severity of injury and to assess the effectiveness and safety of antidotes.
机译：背景：外渗是静脉（IV）药物从静脉意外泄漏到周围组织的外渗，是患者受伤的医源性原因。据报道外渗发生在0.1％至6.5％的住院患者中。儿童患儿的风险可能更高，因为他们有多种危险因素，包括静脉细小，脆弱，外周血循环减少，毛细血管渗漏和皮下柔性组织。目的：描述儿科三级医院外渗的发生率，确定引起外渗的药物，并描述使用解毒剂处理已确定病例的方法。第二个目的是描述与所用解毒剂相关的不良药物作用。方法：回顾性分析2006年1月1日至2008年8月31日期间有静脉输液药物外渗的儿科患者的病历。使用解毒剂的适当性是根据对外渗治疗的治疗方案的依从性来确定的。结果：总共有42名患者记录了外渗现象，每位患者每天的总发生率为0.04％。在记录有位置的40例病例中，普通儿科病房发生12例（30％），外科病房发生10例（25％），新生儿重症监护室9例（22％），5例（12％）儿科重症监护病房，日间护理为3（8％），急诊科为1（2％）。最常见的药物包括静脉输液（18 [43％]），氯化钾（11 [26％]），抗生素（8 [19％]），肠胃外营养（8 [19％]），氯化钙（2 [5％]）和肾上腺素（2 [5％]）。在某些外渗病例中涉及多种药物。在50％的病例中，决定使用解毒剂和选择解毒剂（如果需要）是适当的。使用解毒剂未报告药物不良作用。结论：外渗发生率低。最常用的药物与文献报道的药物相似。解毒剂具有良好的耐受性，但仅在一半的事件中适当使用。需要进行前瞻性试验以确定损伤的临床严重程度并评估解毒剂的有效性和安全性。

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